Individual provider Active NPI

Dennis Martin Slovacek, RPH

  • Pharmacist
  • South Bend, IN
National Provider Identifier
1083986814
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26091690A Issued in IN
Practice address
1400 E Ireland Rd
South Bend, IN 46614-3452
Phone
(574) 231-8258
NPI assigned
Feb 9, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26091690A IN Primary
Pharmacist 183500000X 051026948 IL

Addresses

Primary practice location

1400 E Ireland Rd
South Bend, IN 46614-3452

Mailing address

2270 W 400 N
Crawfordsville, IN 47933-6103
Phone (762) 362-6482

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
051026948ILMDPharmacist
26091690AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1083986814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 W 400 N",
            "city": "CRAWFORDSVILLE",
            "state": "IN",
            "postal_code": "479336103",
            "telephone_number": "762-362-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E IRELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466143452",
            "telephone_number": "574-231-8258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOVACEK",
        "first_name": "DENNIS",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-09",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26091690A",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051026948",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; 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.