Individual provider Active NPI

Kevin Lee Snoddy, PA-C

  • Physician Assistant
  • Henderson, NV
National Provider Identifier
1902129794
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1206 Issued in NV
Practice address
2310 Corporate Cir Ste 200
Henderson, NV 89074-7729
Phone
(702) 735-8000
Fax
(775) 727-5696
NPI assigned
Mar 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1206 NV Primary

Addresses

Primary practice location

2310 Corporate Cir Ste 200
Henderson, NV 89074-7729

Mailing address

7150 W Sunset Rd Ste 200
Las Vegas, NV 89113-1982
Phone (702) 385-4342

Other identifiers 1

IdentifierTypeStateIssuer
1902129894MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20100721000764 NV Practitioner - Physician Assistant 4486786712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Las Vegas Urology LLPGroup PAC ID 5294713335, 51 clinicians

Practice addresses (Care Compare)

2310 Corporate Cir
Suite 200
Henderson, NV 89074-7729
Phone (702) 735-8000

7150 W Sunset Rd
Las Vegas, NV 89113-1982

Hospital & facility affiliations

  • Valley View Medical Center Hospital, Fort Mohave, AZ, CCN 030117
  • Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055
  • Western Arizona Regional Medical Center Hospital, Bullhead City, AZ, CCN 030101

Merit-based Incentive Payment System (MIPS)

Final score
88.26 of 100Reported as group
Quality
90.39
Improvement activities
40
Cost
78.5

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1206NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Holdings Nevada Inc Past Accepting new patients
Desert View Family Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kevinsnoddy@lvu.medalliesdirect.net

Organizations & group practices 3

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 4

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": "1268006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1902129794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7150 W SUNSET RD STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891131982",
            "telephone_number": "702-385-4342",
            "fax_number": "702-385-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 CORPORATE CIR STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747729",
            "telephone_number": "702-735-8000",
            "fax_number": "775-727-5696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNODDY",
        "first_name": "KEVIN",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-08",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902129894",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.