Active NPI
Patrick Serdula, LPN
- Licensed Practical Nurse
- Batavia, OH
National Provider Identifier
1134510357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN.148798-M-IV
- Practice address
- 2040 US Highway 50
Batavia, OH 45103-8694 - Phone
- (513) 732-7015
- NPI assigned
- Feb 10, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN.148798-M-IV | OH | Primary |
Addresses
Primary practice location
2040 US Highway 50
Batavia, OH 45103-8694
Mailing address
4380 Malsbary Rd
Suite 150
Blue Ash, OH 45242-5644
Phone (513) 793-6444
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 |
|---|---|---|---|
| PN.148798-M-IV | OH | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maxim Healthcare Services, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Home Health Agency
- Blue Ash, OH
- NPI 1306800172
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423526400000",
"number": "1134510357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4380 MALSBARY RD",
"address_2": "SUITE 150",
"city": "BLUE ASH",
"state": "OH",
"postal_code": "452425644",
"telephone_number": "513-793-6444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 US HIGHWAY 50",
"city": "BATAVIA",
"state": "OH",
"postal_code": "451038694",
"telephone_number": "513-732-7015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERDULA",
"first_name": "PATRICK",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-02-10",
"last_updated": "2015-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "PN.148798-M-IV",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Batavia, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.