Taressa Snyder Ariss

Key facts

NPI

1861960650

Entity type

Individual (NPI type 1)

Primary specialty

Case Manager/Care Coordinator 171M00000X

Practice address

5775 Green Rd
Fenton, MI 48430-9218

Phone

(517) 231-9687

NPI assigned

Nov 9, 2018

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

Other names

• Taressa Christina Snyder Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 12, 2018.

{
    "created_epoch": "1541721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1861960650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 GREEN RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484309218",
            "telephone_number": "517-231-9687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 GREEN RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484309218",
            "telephone_number": "517-231-9687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARISS",
        "first_name": "TARESSA",
        "middle_name": "SNYDER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-09",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARESSA",
            "last_name": "SNYDER",
            "middle_name": "CHRISTINA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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All providers in Fenton, MI · Case Manager/Care Coordinator in Michigan