DAVID LEE SNODGRASS NP
NPI 1396217345
Nurse Practitioner - Family in Petal, MS

Q: What is David Snodgrass's NPI number?

The NPI number for David Snodgrass is 1396217345. It was assigned to this individual provider in the NPPES registry on December 31, 2018.

Q: What is David Snodgrass's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: Is David Snodgrass enrolled in Medicare?

No. David Snodgrass has opted out of Medicare through April 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for David Snodgrass was last updated on August 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 31, 2018Opted out of Medicare · through Apr 1, 2028

1146 EVELYN GANDY PKWY, PETAL, MS 39465(601) 584-4309(601) 584-4890 Get Directions Write a Review

NPPES record last updated: August 27, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 27, 2020, Dec 31, 2018 (2 updates tracked since 2018).

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About David Lee Snodgrass Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAVID LEE SNODGRASS NP (NPI 1396217345) is an individual family provider in Petal, Mississippi, licensed in Mississippi (881470) and active in the NPI registry since December 2018. He has opted out of Medicare through April 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1396217345

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameDAVID LEE SNODGRASSCredential: NP

Location Address1146 EVELYN GANDY PKWYPetal, MS 39465-3947

Mailing Address5001 Hardy StHattiesburg, MS 39402-1308 · (601) 268-8549 · Fax (601) 261-5716

Phone(601) 584-4309

Fax(601) 584-4890

Sole ProprietorNo

Enumeration DateDecember 31, 2018

Last NPPES UpdateAugust 27, 20202 updates tracked since enumeration

NPPES CertifiedAugust 27, 2020

✔ NPI 1396217345 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MS · 881470

1146 EVELYN GANDY PKWY, Petal, MS 39465

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

David Lee Snodgrass Np has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2022 through April 1, 2028.

Opt-Out Effective DateApril 1, 2022

Opt-Out In Effect ThroughApril 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39465 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MALLORY STOCKSTILL FNP-C

Nurse Practitioner (Family)