Individual provider Active NPI

Michelle Johnson

  • Pharmacist
  • Eustis, FL
National Provider Identifier
1649792185
Registry record updated Jul 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS56495 Issued in FL
Practice address
1950 N State Road 19
Eustis, FL 32726-6729
Phone
(352) 357-5885
NPI assigned
Jul 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS56495 FL Primary

Addresses

Primary practice location

1950 N State Road 19
Eustis, FL 32726-6729

Mailing address

103 N Lakeshore Blvd
Howey in the Hills, FL 34737-3410
Phone (352) 602-6250

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

State licenses

LicenseStateTypeSpecialty
PS56495FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1500076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500076800000",
    "number": "1649792185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 N LAKESHORE BLVD",
            "city": "HOWEY IN THE HILLS",
            "state": "FL",
            "postal_code": "347373410",
            "telephone_number": "352-602-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 N STATE ROAD 19",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266729",
            "telephone_number": "352-357-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-15",
        "last_updated": "2017-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS56495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eustis, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2017; 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.