Alyssa Brianne Snow, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-734 Issued in AR

Practice address

2012 S Promenade Blvd
Rogers, AR 72758-9073

Phone

(479) 616-1485

Fax

(479) 239-0536

NPI assigned

Sep 13, 2010

Last updated

May 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Alyssa Brianne Vander Heyden Former name

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Northwest Arkansas Ambulatory Services, LLCGroup PAC ID 3779827993, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mercy Northwest Arkansas Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Springdale, AR
  • NPI 1366922320
  Medicare reassignment Care Compare group
• South Arkansas Emergency Physicians LLP

  • Emergency Medicine Physician
  • El Dorado, AR
  • NPI 1942435458
  Medicare reassignment
• Totem Health PLLC

  dba Advanced Primary Care of the Ozarks

  • Family Medicine Physician
  • Springdale, AR
  • NPI 1770100752
  Medicare reassignment
• South Arkansas Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Siloam Springs, AR
  • NPI 1225452055

  Physician Assistant

  NPD
• Icem, LLC

  • Emergency Medicine Physician
  • Indianapolis, IN
  • NPI 1467788208
  NPD (past)

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1912214958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 S PROMENADE BLVD",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727589073",
            "telephone_number": "479-616-1485",
            "fax_number": "479-239-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 S PROMENADE BLVD",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727589073",
            "telephone_number": "479-616-1485",
            "fax_number": "479-239-0536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1068 W Baltimore Pike",
            "address_purpose": "LOCATION",
            "city": "Media",
            "state": "PA",
            "postal_code": "190635104",
            "country_code": "US",
            "telephone_number": "484-227-3224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5320 W Sunset Ave Ste 157",
            "address_purpose": "LOCATION",
            "city": "Springdale",
            "state": "AR",
            "postal_code": "727624410",
            "country_code": "US",
            "telephone_number": "479-966-7331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNOW",
        "first_name": "ALYSSA",
        "middle_name": "BRIANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-13",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "1689",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001210",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AR",
            "license": "PA-734",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA07081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "VANDER HEYDEN",
            "middle_name": "BRIANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Winifer Collins Smith, RN
• Kevin Smithpeters
• Deborah A. Smithyman, PSYD
• Jayden Smittle
• Braelyn Olivia Smorynski
• Melia Snyder, LPC, LCMHC, PHD
• Laura Socha, RBT
• Adam F Socia, DDS
• Soh of Arkansas PLLC Samson Liu MBR (Marcus Black DDS)
• Soh of Arkansas PLLC Samson Liu MBR

• Medical Physician Assistant in Rogers, AR
• Providers in Rogers, AR by specialty
• Medical Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.