Active NPI
Alisa Gail Canillas
- Optician
- Lebanon, NH
National Provider Identifier
1285649079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 596
- Practice address
- 1 Medical Center Dr
Lebanon, NH 03756-1000 - Phone
- (603) 650-2651
- NPI assigned
- Jul 30, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 596 | NH | Primary |
Addresses
Primary practice location
1 Medical Center Dr
Lebanon, NH 03756-1000
Mailing address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 650-2651
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1012026 | Medicaid | VT |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 596 | NH | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318809600000",
"number": "1285649079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"city": "LEBANON",
"state": "NH",
"postal_code": "037561000",
"telephone_number": "603-650-2651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"city": "LEBANON",
"state": "NH",
"postal_code": "037561000",
"telephone_number": "603-650-2651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANILLAS",
"first_name": "ALISA",
"middle_name": "GAIL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-30",
"last_updated": "2011-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NH",
"license": "596",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1012026",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.