Individual provider Active NPI

Jacob L Snow, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Las Vegas, NV
National Provider Identifier
1730321100
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
15891 Issued in NV
Practice address
3131 La Canada St
Suite 244
Las Vegas, NV 89169-2578
Phone
(702) 697-5234
NPI assigned
Apr 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 15891 NV Primary

Addresses

Primary practice location

3131 La Canada St
Suite 244
Las Vegas, NV 89169-2578

Mailing address

3131 La Canada St
Suite 244
Las Vegas, NV 89169-2578
Phone (702) 697-5234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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 1

Enrollment IDStateProvider typePAC IDDetails
I20171019001583 NV Practitioner - Pediatric Medicine 2264748789 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15881NVMDPharmacist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1730321100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 LA CANADA ST",
            "address_2": "SUITE 244",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891692578",
            "telephone_number": "702-697-5234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 LA CANADA ST",
            "address_2": "SUITE 244",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891692578",
            "telephone_number": "702-697-5234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOW",
        "first_name": "JACOB",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-01",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NV",
            "license": "15891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.