Calissta Johnson, PHARMD

Primary specialty

Nutrition Support PharmacistTaxonomy code 1835N1003X

License

55618 Issued in TX

Practice address

2500 S Lakeline Blvd Ste 202
Cedar Park, TX 78613-2969

Phone

(512) 628-1090

Fax

(512) 628-1089

NPI assigned

Jun 2, 2021

Last updated

Jun 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

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.

• Sage Pharmacy and Stores LLC

  • Community/Retail Pharmacy
  • Cedar Park, TX
  • NPI 1023300084
  NPD

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1619543394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 S LAKELINE BLVD STE 202",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132969",
            "telephone_number": "512-628-1090",
            "fax_number": "512-628-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S LAKELINE BLVD STE 202",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132969",
            "telephone_number": "512-628-1090",
            "fax_number": "512-628-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CALISSTA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835N1003X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nutrition Support",
            "state": "TX",
            "license": "55618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JM Acupuncture & Massage
• JMB Counseling, PLLC
• Sharanya N/a Joginpalli, MD
• Soma B Johari, M.D.
• Amy Elaine Johnson, OTR
• Cambre Shonbrae Johnson
• Kristi Johnson
• Nicole Christine Johnson, LCSW
• Robin Fayvonne Johnson, LMSW
• Sherry Johnson, LCDC

• Pharmacist in Cedar Park, TX
• Providers in Cedar Park, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.