Individual provider Active NPI

Michael Joseph Sereika, R.PH.

  • Pharmacist
  • Englewood, OH
National Provider Identifier
1710901947
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03218110 Issued in OH
Practice address
801 Southview Dr
Englewood, OH 45322
Phone
(937) 545-5360
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26016403A IN
Pharmacist 183500000X 03218110 OH Primary

Addresses

Primary practice location

801 Southview Dr
Englewood, OH 45322

Mailing address

801 Southview Dr
Englewood, OH 45322-2212
Phone (937) 545-5360

Other practice location 1

4100 W 3rd St
Building 302 Room 125
Dayton, OH 45428-9000
Phone (937) 268-6511 ext. 1898

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
26016403AINMDPharmacist
03218110OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1710901947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 SOUTHVIEW DR",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453222212",
            "telephone_number": "937-545-5360",
            "fax_number": "937-836-1769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 SOUTHVIEW DR",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "45322",
            "telephone_number": "937-545-5360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 W 3rd St",
            "address_2": "Building 302 Room 125",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454289000",
            "country_code": "US",
            "telephone_number": "937-268-6511 x1898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEREIKA",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26016403A",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03218110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.