Active NPI
Gregory James Serocki, RPH
- Pharmacotherapy Pharmacist
- Springfield, MO
National Provider Identifier
1295018422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 2000148968
- Practice address
- 3189 S Woodstock Ave
Springfield, MO 65809-4146 - Phone
- (417) 880-0574
- NPI assigned
- Sep 23, 2011
- Last updated
- Sep 23, 2011
- 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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 2000148968 | MO | Primary |
Addresses
Primary practice location
3189 S Woodstock Ave
Springfield, MO 65809-4146
Mailing address
3189 S Woodstock Ave
Springfield, MO 65809-4146
Phone (417) 880-0574
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2000148968 | MO | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316736000000",
"number": "1295018422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3189 S WOODSTOCK AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658094146",
"telephone_number": "417-880-0574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3189 S WOODSTOCK AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658094146",
"telephone_number": "417-880-0574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEROCKI",
"first_name": "GREGORY",
"middle_name": "JAMES",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-23",
"last_updated": "2011-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "MO",
"license": "2000148968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
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- Nancy M. Service, PH.D
- Nika L Sessionreed, DRIVER
- Ichha Sethi, MD
- Prince Sethi, M.D.
- Sonam Sethi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.