Active NPI
Paul L Snodderley, MD
- Specialist
- Fort Collins, CO
National Provider Identifier
1871524967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 24781
- Practice address
- 1024 S Lemay Ave
Fort Collins, CO 80524-3929 - Phone
- (970) 495-8006
- NPI assigned
- Jul 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 24781 | CO | Primary |
Addresses
Primary practice location
1024 S Lemay Ave
Fort Collins, CO 80524-3929
Mailing address
PO Box 7179
Loveland, CO 80537-0179
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01247816 | Medicaid | CO |
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 |
|---|---|---|---|
| 24781 | CO | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871524967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7179",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805370179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1024 S LEMAY AVE",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805243929",
"telephone_number": "970-495-8006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNODDERLEY",
"first_name": "PAUL",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CO",
"license": "24781",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01247816",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.