Individual provider Active NPI

Nimisha Kizhkkethara, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Alvin, TX
National Provider Identifier
1659979177
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
58955 Issued in TX
Practice address
3100 S Highway 35
Alvin, TX 77511-1413
Phone
(281) 388-3403
NPI assigned
Oct 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 58955 TX Primary

Addresses

Primary practice location

3100 S Highway 35
Alvin, TX 77511-1413

Mailing address

2715 Crawford St
Houston, TX 77004-1118

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
58955TXMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Texas LP PastSince Oct 19, 2020 Accepting new patients
Kroger Texas L P PastSince Oct 19, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1602806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1659979177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 CRAWFORD ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770041118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 S HIGHWAY 35",
            "city": "ALVIN",
            "state": "TX",
            "postal_code": "775111413",
            "telephone_number": "281-388-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIZHKKETHARA",
        "first_name": "NIMISHA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-16",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TX",
            "license": "58955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alvin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; 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.