Individual provider Active NPI

Jessica Marie Snow, PNP

  • Pediatric Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1912013178
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024169681 Issued in VA
Practice address
1000 E Broad St
Richmond, VA 23219-1930
Phone
(804) 828-9111
Fax
(804) 828-0139
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN115481 AZ
Pediatric Nurse Practitioner 363LP0200X 0024169681 VA Primary

Addresses

Primary practice location

1000 E Broad St
Richmond, VA 23219-1930

Mailing address

PO Box 980125 BLDG C Managed Care
Philadelphia, PA 19178-0125
Phone (804) 922-4844

Other practice location 1

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 546-1000

Other names 1

  • Jessica Chetlen Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111214000928 VA Practitioner - Nurse Practitioner 4880690866 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN115481AZMDPediatric Nurse Practitioner
0024169681VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America, LLC CurrentSince May 1, 2022 Accepting new patients
MCV Associated Physicians CurrentSince Jan 21, 2024 Accepting new patients
Cep America LLC CurrentSince May 1, 2022 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

1000 E Broad St
Richmond, VA 23219

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.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1912013178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 980125 BLDG C MANAGED CARE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191780125",
            "telephone_number": "804-922-4844",
            "fax_number": "602-546-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E BROAD ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232191930",
            "telephone_number": "804-828-9111",
            "fax_number": "804-828-0139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 E Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850167710",
            "country_code": "US",
            "telephone_number": "602-546-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNOW",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "RN115481",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024169681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "CHETLEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.