Organization Active NPI

David L Snow MD PC

  • Specialist
  • Maryville, TN
National Provider Identifier
1649547340
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
21006 Issued in TN
Legal business name
DAVID L SNOW MD PC
Practice address
659 Morganton Square Dr
Maryville, TN 37801-4763
Phone
(865) 984-9933
Fax
(865) 982-9428
NPI assigned
Nov 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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

Authorized official

Name
Dr. David L Snow, M.D.NPI 1821096041
Title
Owner
Phone
(865) 984-9933

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 21006 TN Primary

Addresses

Primary practice location

659 Morganton Square Dr
Maryville, TN 37801-4763

Mailing address

659 Morganton Square Dr
Maryville, TN 37801-4763
Phone (865) 984-9933

Other identifiers 1

IdentifierTypeStateIssuer
3059265MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111128000167 TN Part B Supplier - Clinic/Group Practice 3476727629 Receives reassigned benefits from 1 practitioner
Practice locations: Maryville, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2076794David L Snow MD PC659 Morganton SE Dr, Maryville, TN 37801Certificate of waiverApr 24, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322006400000",
    "number": "1649547340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 MORGANTON SQUARE DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014763",
            "telephone_number": "865-984-9933",
            "fax_number": "865-982-9428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 MORGANTON SQUARE DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014763",
            "telephone_number": "865-984-9933",
            "fax_number": "865-982-9428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID L SNOW MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-23",
        "last_updated": "2011-11-23",
        "status": "A",
        "authorized_official_last_name": "SNOW",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-984-9933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": "21006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3059265",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.