Active NPI
John Douglas Snowden, PA-C
- Physician Assistant
- Sneedville, TN
National Provider Identifier
1629072160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 634
- Practice address
- 1861 Main St
Sneedville, TN 37869-3645 - Phone
- (423) 733-2131
- Fax
- (423) 733-1055
- NPI assigned
- Jun 13, 2005
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 634 | TN | Primary |
Addresses
Primary practice location
1861 Main St
Sneedville, TN 37869-3645
Mailing address
303 NW 11TH St
Fairfield, IL 62837-1203
Phone (618) 847-8243
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4176065 | Other | TN | BCBST |
| 36672101 | Medicaid | TN |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 634 | TN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rural Health Services Consortium of Upper East Tennessee Inc | Past | Accepting new patients | |
| Rural Health Services Consortium of Upper East Tennessee Inc | Past | Accepting new patients |
Interoperability endpoints
- jsnowden.p2@direct.horizonhealthcare.nextgenshare.com
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 and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Kingsport, TN
- NPI 1255130027
-
- Federally Qualified Health Center (FQHC)
- Sneedville, TN
- NPI 1861492431
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550448000000",
"number": "1629072160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 NW 11TH ST",
"city": "FAIRFIELD",
"state": "IL",
"postal_code": "628371203",
"telephone_number": "618-847-8243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1861 MAIN ST",
"city": "SNEEDVILLE",
"state": "TN",
"postal_code": "378693645",
"telephone_number": "423-733-2131",
"fax_number": "423-733-1055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNOWDEN",
"first_name": "JOHN",
"middle_name": "DOUGLAS",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-13",
"last_updated": "2019-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "634",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBST",
"identifier": "4176065",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36672101",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sneedville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.