Tina L Snodgrass, APRN, FNP-C

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

3002620 Issued in KY

Practice address

1219 N Main St Ste 2
Beaver Dam, KY 42320-8955

Phone

(270) 926-0707

NPI assigned

Oct 4, 2006

Last updated

Apr 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

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

Nurse Practitioner

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tina Snodgrass Derm, PLLC

  • Family Nurse Practitioner
  • Beaver Dam, KY
  • NPI 1619219581
  Medicare reassignment NPD Authorized official
• Joyce a Haislip, MD.,PSC

  • Internal Medicine Physician
  • Owensboro, KY
  • NPI 1982659637
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1962598557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 N MAIN ST STE 2",
            "city": "BEAVER DAM",
            "state": "KY",
            "postal_code": "423208955",
            "telephone_number": "270-926-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 N MAIN ST STE 2",
            "city": "BEAVER DAM",
            "state": "KY",
            "postal_code": "423208955",
            "telephone_number": "270-926-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNODGRASS",
        "first_name": "TINA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3002620",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "3002620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "K030132",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "K080520",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Rose
• Wendy Russell, LPCC
• Leslie Ellen Sampley, PHARMD
• Shelby Shelby, RDN, LD
• Jonathan L Shrewsbury, O.D.
• Sprouts Therapy Center
• Joan Steiner, OTR/L
• Tamarlane Industries, Inc.
• Tele Nurse Practitioner, PLLC
• Randall Keith Thorpe, PHARMD

• Dermatology Physician in Beaver Dam, KY
• Providers in Beaver Dam, KY by specialty
• Dermatology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.