Active NPI
Jonathon A Snider, PSY.D.
- Psychologist
- Wausau, WI
National Provider Identifier
1720275530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2329-57
- Practice address
- 1100 Lake View Dr
Wausau, WI 54403-6785 - Phone
- (715) 848-4600
- Fax
- (715) 845-5398
- NPI assigned
- Sep 26, 2007
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2329-57 | WI | Primary |
Addresses
Primary practice location
1100 Lake View Dr
Wausau, WI 54403-6785
Mailing address
1100 Lake View Dr
Wausau, WI 54403-6785
Phone (715) 848-4600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2329-57 | WI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492387200000",
"number": "1720275530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 LAKE VIEW DR",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544036785",
"telephone_number": "715-848-4600",
"fax_number": "715-845-5398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 LAKE VIEW DR",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544036785",
"telephone_number": "715-848-4600",
"fax_number": "715-845-5398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNIDER",
"first_name": "JONATHON",
"middle_name": "A",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-26",
"last_updated": "2017-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WI",
"license": "2329-57",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wausau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; 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.