Active NPI
Manual A. Casanova, M.D.
- Diagnostic Radiology Physician
- Gallipolis, OH
National Provider Identifier
1225080203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 35-04-1898
- Practice address
- 90 Jackson Pike
Gallipolis, OH 45631-1560 - Phone
- (740) 446-5709
- Fax
- (740) 446-5697
- NPI assigned
- May 17, 2006
- Last updated
- Feb 11, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 35-04-1898 | OH | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 15247 | WV |
Addresses
Primary practice location
90 Jackson Pike
Gallipolis, OH 45631-1560
Mailing address
90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 441-1934
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0118150000 | Medicaid | WV | |
| 0465296 | Other | OH | MOLINA MEDICAID |
| 001714053 | Other | MOUNTAIN STATE BCBS | |
| 000000193267 | Other | OH | UNISON MEDICAID |
| 000000007167 | Other | ANTHEM BCBS | |
| 300028173 | Other | RR MEDICARE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265846400000",
"number": "1225080203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 JACKSON PIKE",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311560",
"telephone_number": "740-441-1934",
"fax_number": "740-446-5982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 JACKSON PIKE",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311560",
"telephone_number": "740-446-5709",
"fax_number": "740-446-5697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASANOVA",
"first_name": "MANUAL",
"middle_name": "A.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2010-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OH",
"license": "35-04-1898",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WV",
"license": "15247",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0118150000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOLINA MEDICAID",
"identifier": "0465296",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOUNTAIN STATE BCBS",
"identifier": "001714053",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON MEDICAID",
"identifier": "000000193267",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000007167",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "300028173",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Gallipolis, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.