Ivan T. Snowden, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036-058846 Issued in IL

Practice address

1005 Health Center Drive
Mattoon, IL 61938

Phone

(217) 258-4006

Fax

(217) 258-4120

NPI assigned

Aug 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, SC2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sarah Bush Lincoln Health Center

  • General Acute Care Hospital
  • Mattoon, IL
  • NPI 1669564662
  Medicare reassignment NPD
• Sarah Bush Lincoln Health Center

  • Rural Health Clinic/Center
  • Greenville, IL
  • NPI 1811858970
  NPD
• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1164477725
  NPD (past)
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1720194483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 N SEMINARY ST",
            "address_2": "SUITE 100",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012852",
            "telephone_number": "309-343-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 HEALTH CENTER DRIVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "61938",
            "telephone_number": "217-258-4006",
            "fax_number": "217-258-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOWDEN",
        "first_name": "IVAN",
        "middle_name": "T.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-058846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Smith, M.D.
• Tricia Smith, AS
• Erin Smitley
• Jean M Smitley, MS, CCC SCP
• Emily Marie Snively, HS, RSA
• Richard M Snowden, M.D.
• Joseph P. So, M.D.
• Southern Illinois Healthcare Foundation, Inc
• Southern Illinois Healthcare Foundation, Inc
• Amber Sowers, APRN

• Pediatrics Physician in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.