Active NPI
Ramon Lacanilao, MD
- Pediatrics Physician
- Beckley, WV
National Provider Identifier
1124133228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 22204
- Practice address
- 30 Mallard Court
Beckley, WV 25801-3140 - Phone
- (304) 255-0800
- Fax
- (304) 255-1040
- NPI assigned
- Aug 20, 2006
- Last updated
- Jan 28, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 22204 | WV | Primary |
Addresses
Primary practice location
30 Mallard Court
Beckley, WV 25801-3140
Mailing address
30 Mallard Court
Beckley, WV 25801-3140
Phone (304) 255-0800
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22204 | WV | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264636800000",
"number": "1124133228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 MALLARD COURT",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258013140",
"telephone_number": "304-255-0800",
"fax_number": "304-255-1040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 MALLARD COURT",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258013140",
"telephone_number": "304-255-0800",
"fax_number": "304-255-1040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACANILAO",
"first_name": "RAMON",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2010-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WV",
"license": "22204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beckley, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.