Active NPI
Norman I Snyder, MD
- Child & Adolescent Psychiatry Physician
- Fayetteville, AR
National Provider Identifier
1689617417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- R4362
- Practice address
- 4253 N Crossover Rd
Suite 2
Fayetteville, AR 72703-4593 - Phone
- (479) 442-8577
- Fax
- (479) 442-2563
- NPI assigned
- Jun 13, 2006
- 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 |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | R4362 | AR | Primary |
Addresses
Primary practice location
4253 N Crossover Rd
Suite 2
Fayetteville, AR 72703-4593
Mailing address
4253 N Crossover Rd
Fayetteville, AR 72703-4593
Phone (479) 442-8577
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55757 | Other | AR | BLUE CROSS |
| 13034000000 | Other | AR | QUALCHOICE QCA |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R4362 | AR | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184025600000",
"number": "1689617417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4253 N CROSSOVER RD",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034593",
"telephone_number": "479-442-8577",
"fax_number": "479-442-2563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4253 N CROSSOVER RD",
"address_2": "SUITE 2",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034593",
"telephone_number": "479-442-8577",
"fax_number": "479-442-2563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNYDER",
"first_name": "NORMAN",
"middle_name": "I",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2007-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "AR",
"license": "R4362",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "55757",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUALCHOICE QCA",
"identifier": "13034000000",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.