Dominic Cerra, PHARM BS

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH 3951 Issued in HI

Practice address

681 Imihale St
Kihei, HI 96753-6057

Phone

(949) 235-6951

NPI assigned

Jul 20, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science, Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1801249362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 IMIHALE ST",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967536057",
            "telephone_number": "949-235-6951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 IMIHALE ST",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967536057",
            "telephone_number": "949-235-6951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERRA",
        "first_name": "DOMINIC",
        "credential": "PHARM BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "HI",
            "license": "PH 3951",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "44776",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP0356691",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Kihei, HI
• Pharmacist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; 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.