DR. TRACY CASANOVA (NPI# 1548781453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548781453 |
| Entity Type | Individual |
| Full Name | DR. TRACY CASANOVA |
| Credential | PHD |
| Practice Address |
3405 Mike Padgett Hwy Augusta GA 30906 |
| Mailing Address |
3405 Mike Padgett Hwy Augusta GA 30906-3815 |
| Practice Telephone | 7067907085 |
| Mailing Telephone | 7067907085 |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2019-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY004139 | GA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Freedom Way, Augusta, GA 309046258 | 7067330188 |
| Street Address |
3405 MIKE PADGETT HWY |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548288632 | Mona H Hanna | Psychiatry & Neurology | 3405 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2006-07-17 |
| 1912521394 | Cassandra Groth | Psychologist | 3405 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2020-06-02 |
| 1619536737 | David Armando Vivas Villarreal | Psychiatry & Neurology | 3405 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2019-06-12 |
| 1699261487 | Latasha R Ford | Nurse Practitioner | 3405 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2018-07-05 |
| 1811448806 | Christina M Daniels | Nurse Practitioner | 3405 Mike Padgett Hwy, Augusta, GA 30906 | 2016-10-14 |
| 1528489523 | Laurie Ragatz | Psychologist | 3405 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2013-12-18 |
| 1396176145 | Linda Vitacco | Psychologist | 3405 Mike Padgett Hwy, Attention Patient Accounts, Augusta, GA 30906-3815 | 2013-12-04 |
| 1669809455 | Lynne Anne Daurelle | Psychologist | 3405 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2013-10-11 |
| 1255681243 | Maria Bratoeva | Nurse Practitioner | 3405 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2012-09-17 |
| 1114200029 | Benaissa Kaddour Djebbar | Nurse Practitioner | 3405 Mike Padgett Hwy, East Central Regional Hospital -forensic Unit, Augusta, GA 30906-3815 | 2011-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255969432 | Barton Chapel Dental Group, LLC | Dentist | 2755 Barton Chapel Road, Augusta, GA 30906 | 2020-04-01 |
| 1255897419 | Pediatric Mobility Innovations | Durable Medical Equipment & Medical Supplies | 3114 Augusta Tech Drive Suite 404, Augusta, GA 30906 | 2019-02-13 |
| 1023539731 | Kristy Lee Gibbs | Registered Nurse | 3421 Mike Padgett Hwy Bldg C, Augusta, GA 30906 | 2017-07-03 |
| 1194186031 | Clifton Nane Williams | Counselor | 3230 Hampton Circle, Augusta, GA 30906 | 2016-03-18 |
| 1376929661 | Catherine A. Ganzy | Social Worker | 3405 Mike Padgett Highway; Building 201, East Central Regional Hosptial, Augusta, GA 30906 | 2015-08-10 |
| 1962810358 | Fatemeh Azadeh Paziraei | Dentist | 1631 Gordon Highway, Augusta Smiles Youth Dentistry, Augusta, GA 30906 | 2014-07-29 |
| 1568809770 | Brandon Jennings | Occupational Therapy Assistant | 2388 Old Mcduffie Rd, Augusta, GA 30906 | 2013-05-29 |
| 1811266646 | Eddie P Johnson IIi, Dmd, PC | Preferred Provider Organization | 2755 Barton Chapel Rd, Augusta, GA 30906 | 2011-12-23 |
| 1366739021 | Kerensa A Cooks | Registered Nurse | 3421 Mike Padgett Highway, Serenity Behavioral Health Systems, Augusta, GA 30906 | 2011-07-01 |
| 1265737423 | Pidcock Chiropractic, Inc. | Chiropractor | 3028 Peach Orchard Rd., Augusta, GA 30906 | 2011-01-20 |
| Find all providers in zip 30906 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598397838 | Mjra Medical LLC | Psychologist | 3675 J Dewey Gray Cr Ste 300, Augusta, GA 30909 | 2020-02-05 |
| 1932635885 | Samantha L. Whatson | Psychologist | 3633 Wheeler Rd Ste 110, Augusta, GA 30909-6544 | 2017-05-11 |
| 1942743679 | Medoptions of Maine, LLC | Psychologist | 45 Memorial Cir, Augusta, ME 04330-6400 | 2016-11-29 |
| 1942652656 | Nancy Slobodnik | Psychologist | 1 Va Ctr # 28, Augusta, ME 04330-6719 | 2016-07-06 |
| 1710315171 | Holly Tabernik | Psychologist | 3405 Mike Padgett Hwy Bldg 10, Augusta, GA 30906-3815 | 2013-10-23 |
| 1225383078 | Sarah Bruce Stevens | Psychologist | 44 Thornberry Drive, Augusta, GA 30909-1922 | 2012-07-18 |
| 1326277831 | Katharine Elliott Mocciola | Psychologist | 1 Va Ctr # 116b, Augusta, ME 04330-6719 | 2009-07-06 |
| 1467635441 | Dana P. Reaume | Psychologist | 74 Bristlecone Ln, Augusta, GA 30909-1847 | 2007-12-12 |
| 1548460124 | Sarah Faith Shelton | Psychologist | 1829 Wrightsboro Rd, Augusta, GA 30904-2010 | 2007-07-20 |
| 1679623086 | M. Kevin Turner | Psychologist | 103 Rossmore Pl, Augusta, GA 30909-5769 | 2007-01-11 |
| Find all providers in AUGUSTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.