Savanna Jaye Snow, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085.010776 Issued in IL

Practice address

420 NE Glen Oak Ave
Peoria, IL 61603-3106

Phone

(618) 218-8241

NPI assigned

Aug 27, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Savanna Jaye Staley Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

{
    "created_epoch": "1724716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1952135576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23799 SPRING CREEK RD",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615719667",
            "telephone_number": "618-218-8241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033106",
            "telephone_number": "618-218-8241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23799 Spring Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "IL",
            "postal_code": "615719667",
            "country_code": "US",
            "telephone_number": "618-218-8241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNOW",
        "first_name": "SAVANNA",
        "middle_name": "JAYE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-27",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.010776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAVANNA",
            "last_name": "STALEY",
            "middle_name": "JAYE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Harry Robinson Smouse, MD
• Sara Snarr, APN
• Theresa L. Snedden, PT
• Brenyn R Snider, CNM-APRN
• Kevin Snow, PA-C
• Amy Rebecca Snowden, PHARMD
• Snyder Counseling Services, PLLC
• Brenda Snyder, LCSW
• Denise Rae Snyder, PTA
• Lisa E. Snyder, MD

• Medical Physician Assistant in Peoria, IL
• Providers in Peoria, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.

Verify at the official NPI Registry.