Individual provider Active NPI

Glenn C Snyders, MD

  • Pediatrics Physician
  • Virginia Beach, VA
National Provider Identifier
1881669174
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101039454 Issued in VA
Practice address
1800 Camelot Dr
Ste 200
Virginia Beach, VA 23454-2440
Phone
(757) 491-7337
Fax
(757) 491-2233
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101039454 VA Primary

Addresses

Primary practice location

1800 Camelot Dr
Ste 200
Virginia Beach, VA 23454-2440

Mailing address

1800 Camelot Dr
Ste 200
Virginia Beach, VA 23454-2440
Phone (757) 491-7337

Other identifiers 1

IdentifierTypeStateIssuer
006720048MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20110303000797 VA Practitioner - Pediatric Medicine 9234311812 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101039454VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Pediatrics CurrentSince Oct 20, 2010 Accepting new patients

Locations

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

1800 Camelot Dr
Ste 200
Virginia Beach, VA 23454
Phone (757) 252-9600

Interoperability endpoints

  • Direct secure messaging: gsnyders12768@direct.sentara.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1881669174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 CAMELOT DR",
            "address_2": "STE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542440",
            "telephone_number": "757-491-7337",
            "fax_number": "757-491-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 CAMELOT DR",
            "address_2": "STE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542440",
            "telephone_number": "757-491-7337",
            "fax_number": "757-491-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDERS",
        "first_name": "GLENN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101039454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006720048",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.