Richard James Serkowski, DO, MPH, CPE

Primary specialty

Aerospace Medicine PhysicianTaxonomy code 2083A0100X

License

42767 Issued in WI

Practice address

511 N Torch Blvd
BLDG 300
Cannon Afb, NM 88103-5109

Phone

(575) 784-0287

NPI assigned

Jan 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1174502090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1599 J ST BLDG 109",
            "city": "GRAND FORKS AFB",
            "state": "ND",
            "postal_code": "582056332",
            "telephone_number": "701-747-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 N TORCH BLVD",
            "address_2": "BLDG 300",
            "city": "CANNON AFB",
            "state": "NM",
            "postal_code": "881035109",
            "telephone_number": "575-784-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERKOWSKI",
        "first_name": "RICHARD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DO, MPH, CPE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WI",
            "license": "42767-021",
            "primary": false
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "WI",
            "license": "42767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joketha Faith Ross, RN-BSN
• Danielle Markeeta Sales, DNP, APRN, WHNP-BC
• David A Sarnow, M.D., MPH
• Ray Leroy Schatz III, IDMT
• Kelly Amanda Schneider, DDS
• June Ellen Shepherd, PH.D.
• Luke Smith, DMD
• Nicholas Kenneth Smythe III, PH.D. IN PROGRESS
• Andrew Springstead
• Justin D Sterett, M.D.

• Aerospace Medicine Physician in Cannon Afb, NM
• Providers in Cannon Afb, NM by specialty
• Aerospace Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; 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.