Individual provider Active NPI

John P. Sneden, MD

  • Internal Medicine Physician
  • Watertown, SD
National Provider Identifier
1811999659
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4238 Issued in SD
Practice address
917 29TH St SE
Watertown, SD 57201-9123
Phone
(605) 884-2420
Fax
(605) 884-2425
NPI assigned
Aug 11, 2005
Last updated
Dec 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4238 SD Primary

Addresses

Primary practice location

917 29TH St SE
Watertown, SD 57201-9123

Mailing address

917 29TH St SE
Watertown, SD 57201-9123
Phone (605) 884-2420

Other identifiers 2

IdentifierTypeStateIssuer
A021OtherTRICARE
6003042MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20130509000292 SD Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9436292588

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4238SDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Huron Clinic Foundation LTD Current Accepting new patients

Locations

111 4th St SE
Huron, SD 57350
Phone (605) 352-8691

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1811999659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 29TH ST SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572019123",
            "telephone_number": "605-884-2420",
            "fax_number": "605-884-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 29TH ST SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572019123",
            "telephone_number": "605-884-2420",
            "fax_number": "605-884-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNEDEN",
        "first_name": "JOHN",
        "middle_name": "P.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "4238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A021",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003042",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

Verify at the official NPI Registry.