TINA SNODGRASS DERM, PLLC
NPI 1619219581
Nurse Practitioner - Family in Beaver Dam, KY
About Tina Snodgrass Derm, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TINA SNODGRASS DERM, PLLC (NPI 1619219581) is a healthcare organization registered as a family in Beaver Dam, Kentucky and active in the NPI registry since March 2013. The organization lists Tina Snodgrass, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tina Snodgrass Derm, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Tina Snodgrass Derm, PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Tina Snodgrass Derm, PLLC's NPI number?
The NPI number for Tina Snodgrass Derm, PLLC is 1619219581. It was assigned to this organization in the NPPES registry on March 19, 2013.
Where is Tina Snodgrass Derm, PLLC located?
Tina Snodgrass Derm, PLLC is located at 1219 N Main St Ste 2, Beaver Dam, KY 42320. The listed phone number is (270) 926-0707.
What is Tina Snodgrass Derm, PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Tina Snodgrass Derm, PLLC enrolled in Medicare?
Yes. Tina Snodgrass Derm, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Tina Snodgrass Derm, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Tina Snodgrass Derm, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Tina Snodgrass Derm, PLLC was last updated on December 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.
# Tina Snodgrass Derm, Pllc · NPI 1619219581
Family organization in Beaver Dam, Kentucky. Organization record, active in the CMS NPPES registry since March 19, 2013.
## Identity
- **NPI:** 1619219581 (Entity type: Organization)
- **Enumerated:** March 19, 2013
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Tina Snodgrass, PRESIDENT
## Practice location
- **Address:** 1219 N MAIN ST STE 2, Beaver Dam, KY 42320-8955
- **Phone:** (270) 926-0707
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 5, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1619219581) · Data from the CMS NPPES public registry.