Individual provider Active NPI

Mary Esther Canava, NPC

  • Family Nurse Practitioner
  • Georgetown, TX
National Provider Identifier
1760411144
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
524937 Issued in TX
Practice address
1231 Leander Rd
Georgetown, TX 78628-8707
Phone
(512) 819-0790
Fax
(512) 819-0799
NPI assigned
Jun 30, 2006
Last updated
Sep 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 524937 TX Primary

Addresses

Primary practice location

1231 Leander Rd
Georgetown, TX 78628-8707

Mailing address

902 Crystal Falls Pkwy
Leander, TX 78641-3646
Phone (512) 259-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060817000632 TX Practitioner - Nurse Practitioner 2769485416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
CLP Regency of Texas LLCGroup PAC ID 7214006477, 3 clinicians

Practice addresses (Care Compare)

1717 N Ih
35 Suite 130
Round Rock, TX 78664-2901
Phone (512) 246-7127

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
524937TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CLP Regency of Texas, LLC Family CurrentSince Oct 24, 2024 Accepting new patients
Certified Nurse Practitioners, PC Family PastSince Dec 22, 2018 Accepting new patients
Domicilliary Service LLC Past Accepting new patients
Diabetes & Endocrine Center of Central Texas PA PastSince Jul 1, 2010 Accepting new patients

Locations

10 Cadillac Dr
Ste 400
Brentwood, TN 37027
Phone (615) 637-9163

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1760411144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 CRYSTAL FALLS PKWY",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786413646",
            "telephone_number": "512-259-2222",
            "fax_number": "512-259-2290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 LEANDER RD",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786288707",
            "telephone_number": "512-819-0790",
            "fax_number": "512-819-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANAVA",
        "first_name": "MARY",
        "middle_name": "ESTHER",
        "name_prefix": "Mrs.",
        "credential": "NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "524937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.