Active NPI
Lilly Koutcho
- Ambulatory Care Pharmacist
- Muskogee, OK
National Provider Identifier
1154213411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 1569
- Practice address
- 304 N York St
Muskogee, OK 74403 - Phone
- (918) 683-1570
- NPI assigned
- Jul 19, 2025
- Last updated
- Jul 19, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 1569 | OK | Primary |
Addresses
Primary practice location
304 N York St
Muskogee, OK 74403
Mailing address
8413 E 163Rd Street S
Bixby, OK 74008
Phone (913) 951-9240
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oklahoma CVS Pharmacy LLC | Past | Accepting new patients | |
| Oklahoma CVS Pharmacy, L.L.C. | Past | Accepting new patients |
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": "1752883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752883200000",
"number": "1154213411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8413 E 163RD STREET S",
"city": "BIXBY",
"state": "OK",
"postal_code": "74008",
"telephone_number": "913-951-9240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 N YORK ST",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "74403",
"telephone_number": "918-683-1570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOUTCHO",
"first_name": "LILLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-19",
"last_updated": "2025-07-19",
"certification_date": "2025-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "OK",
"license": "1569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muskogee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.