Individual provider Active NPI

Gabrielle Nicole Snellgrove, CRNP, RNFA

  • Acute Care Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1831856780
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-169551 Issued in AL
Practice address
102 Doctors Dr
Dothan, AL 36301-2911
Phone
(334) 792-5184
NPI assigned
Nov 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2100X 1-169551 AL Primary

Addresses

Primary practice location

102 Doctors Dr
Dothan, AL 36301-2911

Mailing address

102 Doctors Dr
Dothan, AL 36301-2911
Phone (334) 792-5184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231206000395 AL Practitioner - Nurse Practitioner 0749639599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston County Healthcare AuthorityGroup PAC ID 9436062296, 256 clinicians

Practice addresses (Care Compare)

102 Doctors Dr
Dothan, AL 36301-2911
Phone (334) 793-6573

Hospital & facility affiliations

  • Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Healthcare Authority Single Specialty Current Accepting new patients
Houston County Healthcare Authority Single Specialty Current Accepting new patients
Houston County Healthcare Authority Single Specialty CurrentSince Oct 28, 2023 Accepting new patients
Southeast Alabama Medical Center Employee Pharmacy Past Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

1118 Ross Clark Cir
Ste 200
Dothan, AL 36301
Phone (334) 793-4804

102 Doctors Dr
Dothan, AL 36301
Phone (334) 793-8804

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1831856780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 DOCTORS DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012911",
            "telephone_number": "334-792-5184",
            "fax_number": "334-792-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 DOCTORS DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012911",
            "telephone_number": "334-792-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNELLGROVE",
        "first_name": "GABRIELLE",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "CRNP, RNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-24",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-169551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.