Individual provider Active NPI

Amber Michelle Casanova, PHARMD

  • Pharmacist
  • San Antonio, TX
National Provider Identifier
1063002517
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
51707 Issued in TX
Practice address
10718 Potranco Rd
San Antonio, TX 78251-3312
Phone
(210) 681-2250
NPI assigned
Jan 19, 2021
Last updated
Jan 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 51707 TX Primary

Addresses

Primary practice location

10718 Potranco Rd
San Antonio, TX 78251-3312

Mailing address

11203 Hill Top Loop
Helotes, TX 78023-4778
Phone (210) 861-5762

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL na

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
51707TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1063002517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11203 HILL TOP LOOP",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780234778",
            "telephone_number": "210-861-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10718 POTRANCO RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782513312",
            "telephone_number": "210-681-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASANOVA",
        "first_name": "AMBER",
        "middle_name": "MICHELLE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "51707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "na",
            "affiliation": "N",
            "address_1": "10718 Potranco Rd",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782513312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.