Organization Active NPI

William E. Snell DO PC

Doing business as Kenmar Family Practice

  • General Practice Physician
  • Marietta, GA
National Provider Identifier
1659593077
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
024495 Issued in GA
Legal business name
WILLIAM E. SNELL DO PC
Doing business as
Kenmar Family Practice
Practice address
880 Canton Road
Suite 300
Marietta, GA 30060-7283
Phone
(770) 590-0585
Fax
(770) 428-4087
NPI assigned
May 3, 2007
Last updated
Jan 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Authorized official

Name
Dr. William Edward Snell, D.O.NPI 1013932003
Title
President
Phone
(770) 590-0585

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
General Practice Physician 208D00000X 024495 GA Primary

Addresses

Primary practice location

880 Canton Road
Suite 300
Marietta, GA 30060-7283

Mailing address

880 Canton Road
Suite 300
Marietta, GA 30060-7283
Phone (770) 590-0585

Other identifiers 3

IdentifierTypeStateIssuer
DG6106OtherGARAILROAD MEDICARE
GRP4464OtherGAMEDICARE
000273391AMedicaidGA

Other names 2

  • Kenmar Family Practice Doing business as
  • William E. Snell D.O. , P.C. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050429000174 GA Part B Supplier - Clinic/Group Practice 0042259996 Receives reassigned benefits from 1 practitioner
Practice locations: Marietta, GA

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
11D0708081Kenmar Family Practice880 Canton Road, Suite 300, Marietta, GA 30060Certificate of waiverJan 23, 2028

National Provider Directory

National Provider Directory

Locations

880 Canton Rd NE
Ste 300
Marietta, GA 30060
Phone (770) 590-0585

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1659593077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 CANTON ROAD",
            "address_2": "SUITE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607283",
            "telephone_number": "770-590-0585",
            "fax_number": "770-428-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 CANTON ROAD",
            "address_2": "SUITE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607283",
            "telephone_number": "770-590-0585",
            "fax_number": "770-428-4087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM E. SNELL DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "SNELL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-590-0585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "024495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG6106",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GRP4464",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000273391A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenmar Family Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "William E. Snell D.O. , P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.