Individual provider Active NPI

Laura Casanova, RPH

  • Pharmacist
  • Iron Mountain, MI
National Provider Identifier
1346862646
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302027964 Issued in MI
Practice address
1721 S Stephenson Ave Ste a
Iron Mountain, MI 49801-3637
Phone
(906) 776-5419
Fax
(906) 776-5911
NPI assigned
May 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302027964 MI Primary

Addresses

Primary practice location

1721 S Stephenson Ave Ste a
Iron Mountain, MI 49801-3637

Mailing address

1721 S Stephenson Ave Ste a
Iron Mountain, MI 49801-3637
Phone (906) 776-5419

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302027964MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dickinson County Healthcare System CurrentSince May 24, 2020 Accepting new patients
Dickinson County Healthcare System PastSince May 17, 2020 Accepting new patients

Locations

1721 S Stephenson Ave
Ste A
Iron Mountain, MI 49801
Phone (906) 776-5419

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1346862646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 S STEPHENSON AVE STE A",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013637",
            "telephone_number": "906-776-5419",
            "fax_number": "906-776-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 S STEPHENSON AVE STE A",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013637",
            "telephone_number": "906-776-5419",
            "fax_number": "906-776-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASANOVA",
        "first_name": "LAURA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-11",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302027964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.