Individual provider Active NPI

Jean Marie Snyder, LCSW

  • Clinical Social Worker
  • Roswell, NM
National Provider Identifier
1841690716
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-09428 Issued in NM
Practice address
110 E Mescalero Rd
Roswell, NM 88201-6542
Phone
(575) 755-1486
Fax
(575) 622-3325
NPI assigned
Aug 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C-09428 NM Primary

Addresses

Primary practice location

110 E Mescalero Rd
Roswell, NM 88201-6542

Mailing address

PO Box 483
Portales, NM 88130-0483
Phone (575) 755-1486

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180227001979 NM Practitioner - Clinical Social Worker 5799046173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentry Safety and Physical Therapy Specialists LLCGroup PAC ID 2264730860, 4 clinicians

Practice addresses (Care Compare)

805 N Richardson Ave
Roswell, NM 88201-4920
Phone (575) 622-6260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-09428NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sentry Home Health Care LLC CurrentSince Dec 1, 2022 Accepting new patients
Sentry Safety and Physical Therapy Specialists, LLC Clinical CurrentSince Dec 1, 2022 Accepting new patients

Locations

805 N Richardson Ave
Roswell, NM 88201
Phone (575) 622-6260

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.

NPI Registry JSON

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1841690716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 483",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881300483",
            "telephone_number": "575-755-1486",
            "fax_number": "575-622-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E MESCALERO RD",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882016542",
            "telephone_number": "575-755-1486",
            "fax_number": "575-622-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "JEAN",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-09428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.