Individual provider Active NPI

Shane Britton Snider, DO

  • Emergency Medicine Physician
  • Kissimmee, FL
National Provider Identifier
1669000295
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO.3430 Issued in AL
Practice address
720 W Oak St Ste 201
Kissimmee, FL 34741-4998
Phone
(334) 672-0980
NPI assigned
Mar 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101027656 MI
Emergency Medicine Physician 207P00000X DO.3430 AL Primary

Addresses

Primary practice location

720 W Oak St Ste 201
Kissimmee, FL 34741-4998

Mailing address

720 W Oak St Ste 201
Kissimmee, FL 34741-4998
Phone (334) 672-0980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231004002318 MI Practitioner - Emergency Medicine 3678975232
I20241101002277 AL Practitioner - Emergency Medicine 3678975232 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Laboratory Associates Current Accepting new patients
Houston County Healthcare Authority Emergency Medicine Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Houston County Healthcare Authority CurrentSince Aug 1, 2024 Accepting new patients
Medcore Associates, PLLC Current Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

Organizations & group practices 5

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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1669000295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 W OAK ST STE 201",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414998",
            "telephone_number": "334-672-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W OAK ST STE 201",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414998",
            "telephone_number": "334-672-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNIDER",
        "first_name": "SHANE",
        "middle_name": "BRITTON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-30",
        "last_updated": "2024-08-01",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101027656",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "DO.3430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.