Lisa Renee Kisamore

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS66226 Issued in FL

Practice address

11240 Panama City Beach Pkwy
Panama City Beach, FL 32407-2449

Phone

(850) 233-4590

NPI assigned

Sep 18, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Publix Super Markets Inc

  dba Publix Pharmacy #1241

  • Community/Retail Pharmacy
  • Panama City Beach, FL
  • NPI 1083654461
  NPD (past)
• Publix Super Markets Inc

  dba Publix Pharmacy #2107

  • Community/Retail Pharmacy
  • Winter Haven, FL
  • NPI 1760356380
  NPD (past)

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1568240844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 GRAND PANAMA CIR APT 306",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324073486",
            "telephone_number": "850-545-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11240 PANAMA CITY BEACH PKWY",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324072449",
            "telephone_number": "850-233-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISAMORE",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS66226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra D Keister, RPH
• Sabrina Kelley, CRNP
• Breanna Kern
• Kimberly D Moskowitz Ms MD LLC
• Mark L King, PHARM D
• Frederick G Klepes Jr., DDS
• George Klug, MA, SLP
• Tuesday Knight
• Koala ABA Inc
• Jaclynn Koder

• Pharmacist in Panama City Beach, FL
• Providers in Panama City Beach, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.