Active NPI
Tracey E Snyder, NP
- Nurse Practitioner
- Park Falls, WI
National Provider Identifier
1922115294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 74595
- Practice address
- 50 Sherry Ave
Park Falls, WI 54552 - Phone
- (715) 762-7311
- NPI assigned
- Aug 24, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 74595 | WI | Primary |
Addresses
Primary practice location
50 Sherry Ave
Park Falls, WI 54552
Mailing address
1000 N Oak Ave
Marshfield, WI 54449-5777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43815700 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74595 | WI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922115294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 N OAK AVE",
"city": "MARSHFIELD",
"state": "WI",
"postal_code": "544495777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 SHERRY AVE",
"city": "PARK FALLS",
"state": "WI",
"postal_code": "54552",
"telephone_number": "715-762-7311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNYDER",
"first_name": "TRACEY",
"middle_name": "E",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "74595",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43815700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Park Falls, WI
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.