Active NPI
Erica G Snider-Thammavong, MD
- Family Medicine Physician
- Springboro, OH
National Provider Identifier
1811045198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35.094616
- Practice address
- 5 Sycamore Creek Dr
Springboro, OH 45066-2300 - Phone
- (937) 748-4211
- Fax
- (937) 748-3566
- NPI assigned
- Jan 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 237301 | NY | |
| Family Medicine Physician | 207Q00000X | 35.094616 | OH | Primary |
Addresses
Primary practice location
5 Sycamore Creek Dr
Springboro, OH 45066-2300
Mailing address
5 Sycamore Creek Dr
Springboro, OH 45066-2300
Phone (937) 748-4211
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02705888 | Medicaid | NY | |
| 0058539 | Medicaid | OH |
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 |
|---|---|---|---|
| 237301 | NY | MD | Family Medicine Physician |
| 35.094616 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fort Edward Rescue Squad Inc | Past | Accepting new patients | |
| Chemung Medical Services PC | Family Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Ambulance
- Fort Edward, NY
- NPI 1427031319
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384300800000",
"number": "1811045198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 SYCAMORE CREEK DR",
"city": "SPRINGBORO",
"state": "OH",
"postal_code": "450662300",
"telephone_number": "937-748-4211",
"fax_number": "937-748-3566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 SYCAMORE CREEK DR",
"city": "SPRINGBORO",
"state": "OH",
"postal_code": "450662300",
"telephone_number": "937-748-4211",
"fax_number": "937-748-3566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNIDER-THAMMAVONG",
"first_name": "ERICA",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-05",
"last_updated": "2013-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "237301",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35.094616",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02705888",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0058539",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springboro, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.