Individual provider Active NPI

Morgan Goodelman Snipper, PA-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1962111500
Registry record updated Dec 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1196424 Issued in NV
Practice address
657 N Town Center Dr
Las Vegas, NV 89144-6367
Phone
(702) 233-7000
NPI assigned
Nov 22, 2022
Last updated
Dec 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 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 1196424 NV Primary

Addresses

Primary practice location

657 N Town Center Dr
Las Vegas, NV 89144-6367

Mailing address

2200 S Fort Apache Rd Unit 2068
Las Vegas, NV 89117-5717
Phone (702) 553-7900

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
I20230406002204 NV Practitioner - Physician Assistant 2668847583 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1196424NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Mar 29, 2023 Accepting new patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Mar 29, 2023 Accepting new patients

Locations

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

657 N Town Center Dr
Las Vegas, NV 89144
Phone (702) 233-7571

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703980800000",
    "number": "1962111500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 S FORT APACHE RD UNIT 2068",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175717",
            "telephone_number": "702-553-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 N TOWN CENTER DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891446367",
            "telephone_number": "702-233-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNIPPER",
        "first_name": "MORGAN",
        "middle_name": "GOODELMAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-22",
        "last_updated": "2023-12-31",
        "certification_date": "2023-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "1196424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.