Individual provider Active NPI

Chad Matthew Snyder, PA

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1558051003
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3580 Issued in KY
Practice address
1350 Bull Lea Rd
Lexington, KY 40511-1247
Phone
(859) 246-8000
Fax
(859) 246-8032
NPI assigned
May 9, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA3580 KY
Surgical Physician Assistant 363AS0400X PA3580 KY
Physician Assistant 363A00000X PA3580 KY Primary

Addresses

Primary practice location

1350 Bull Lea Rd
Lexington, KY 40511-1247

Mailing address

650 Joel Dr
Fort Campbell, KY 42223-5318
Phone (931) 241-8589

Other practice location 1

650 Joel Dr
Fort Campbell, KY 42223-5318
Phone (931) 241-8589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241111003882 KY Practitioner - Physician Assistant 3173057395 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
TC081KYMDPhysician Assistant
PA3580KYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Oct 29, 2024 Accepting new patients

Locations

1350 Bull Lea Rd
Lexington, KY 40511
Phone (859) 246-7363

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1558051003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "931-241-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 BULL LEA RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111247",
            "telephone_number": "859-246-8000",
            "fax_number": "859-246-8032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 Joel Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Campbell",
            "state": "KY",
            "postal_code": "422235318",
            "country_code": "US",
            "telephone_number": "931-241-8589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "CHAD",
        "middle_name": "MATTHEW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-09",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA3580",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "PA3580",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA3580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.