NPIMap

Individual provider Active NPI

Charles J Snow, MD

  • Obstetrics & Gynecology Physician
  • Saint Cloud, MN
National Provider Identifier
1689745747
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
49052 Issued in MN
Practice address
1406 Sixth Ave N
St Cloud, MN 56303-1900
Phone
(320) 251-2700
NPI assigned
Nov 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 49052 MN Primary

Addresses

Primary practice location

1406 Sixth Ave N
St Cloud, MN 56303-1900

Mailing address

1406 Sixth Ave N
St Cloud, MN 56303-1900
Phone (320) 251-2700

Other names 1

  • Clark Joseph Golightly Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141015002408 MN Practitioner - Obstetrics/Gynecology 4284804840 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Uniformed Services Uhs Fe Hebert School of Med, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare Clinic Southwest LLCGroup PAC ID 8426457946, 172 clinicians

Practice addresses (Care Compare)

600 Peterson Pkwy
New London, MN 56273-7823
Phone (320) 354-2222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49052MNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Astera Health CurrentSince Apr 10, 2017 Accepting new patients
Unity Family Healthcare Current Accepting new patients
Unity Family Healthcare Current Accepting new patients
Unity Family Healthcare CurrentSince Nov 1, 2023 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Nov 1, 2021 Accepting new patients
Astera Health CurrentSince Apr 10, 2017 Accepting new patients
Unity Family Healthcare CurrentSince Nov 1, 2023 Accepting new patients
Astera Health Current Accepting new patients
Centracare Clinic CurrentSince Jul 1, 2016 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Nov 1, 2021 Accepting new patients
Centracare Clinic Current Accepting new patients
Centracare Clinic Past Accepting new patients
Centracare Clinic Past Accepting new patients
Carris Health LLC Past Accepting new patients

Locations

7892 Solutions Ctr
Chicago, IL 60677

815 2nd St SE
Little Falls, MN 56345
Phone (320) 632-5441

811 2nd St SE
Little Falls, MN 56345
Phone (320) 631-7000

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

415 Jefferson St N
Wadena, MN 56482
Phone (218) 631-3510

4 Deerwood Ave NW
Wadena, MN 56482
Phone (218) 631-1100

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

Interoperability endpoints

  • Direct secure messaging: csnow299317@direct.centracare.com

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1689745747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 SIXTH AVE N",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563031900",
            "telephone_number": "320-251-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 SIXTH AVE N",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563031900",
            "telephone_number": "320-251-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOW",
        "first_name": "CHARLES",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-12",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "49052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLARK",
            "last_name": "GOLIGHTLY",
            "middle_name": "JOSEPH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.