Active NPI
Jeffry B. Snell, PH.D.
- Psychologist
- Sioux City, IA
National Provider Identifier
1598797771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 00967
- Practice address
- 801 5TH St # 6NW
Sioux City, IA 51101-1326 - Phone
- (712) 279-5718
- Fax
- (712) 279-5978
- NPI assigned
- Jul 7, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 00967 | IA | Primary |
Addresses
Primary practice location
801 5TH St # 6NW
Sioux City, IA 51101-1326
Mailing address
PO Box 328
Sioux City, IA 51102-0328
Phone (712) 279-5836
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0447763 | Medicaid | IA | |
| 38170 | Other | IA | WELLMARK |
| 100251285-00 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00967 | IA | MD | Physical Therapy Assistant |
| 552 | NE | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quality Living Inc | Past | Accepting new patients | |
| Quality Living Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Qli Physician's Clinic
- Physical Medicine & Rehabilitation Physician
- Omaha, NE
- NPI 1710458237
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598797771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 328",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511020328",
"telephone_number": "712-279-5836",
"fax_number": "712-279-5883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 5TH ST # 6NW",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511011326",
"telephone_number": "712-279-5718",
"fax_number": "712-279-5978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNELL",
"first_name": "JEFFRY",
"middle_name": "B.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IA",
"license": "00967",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0447763",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "38170",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100251285-00",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sioux City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.