Active NPI
Ebenezer Semere
- Pharmacist
- Port Lavaca, TX
National Provider Identifier
1609597244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 71260
- Practice address
- 1302 N Virginia St
Port Lavaca, TX 77979-2509 - Phone
- (361) 552-7451
- NPI assigned
- Sep 12, 2022
- Last updated
- Sep 12, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 71260 | TX | Primary |
Addresses
Primary practice location
1302 N Virginia St
Port Lavaca, TX 77979-2509
Mailing address
1302 N Virginia St
Port Lavaca, TX 77979-2509
Phone (361) 552-7451
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 |
|---|---|---|---|
| 71260 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1302 N Virginia St
Port Lavaca, TX 77979
Phone (361) 552-7451
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1609597244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1302 N VIRGINIA ST",
"city": "PORT LAVACA",
"state": "TX",
"postal_code": "779792509",
"telephone_number": "361-552-7451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1302 N VIRGINIA ST",
"city": "PORT LAVACA",
"state": "TX",
"postal_code": "779792509",
"telephone_number": "361-552-7451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEMERE",
"first_name": "EBENEZER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-12",
"last_updated": "2022-09-12",
"certification_date": "2022-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "71260",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Lavaca, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.