Mishelle Johnson Kochumuttom, PHARM. D

Primary specialty

PharmacistTaxonomy code 183500000X

License

66294 Issued in TX

Practice address

733 Sun Valley Blvd
Hewitt, TX 76643-3535

Phone

(254) 340-6601

NPI assigned

Aug 15, 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

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1790568756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 SIR TURQUIN LN",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750565756",
            "telephone_number": "469-867-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 SUN VALLEY BLVD",
            "city": "HEWITT",
            "state": "TX",
            "postal_code": "766433535",
            "telephone_number": "254-340-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCHUMUTTOM",
        "first_name": "MISHELLE",
        "middle_name": "JOHNSON",
        "name_prefix": "Dr.",
        "credential": "PHARM. D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "66294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennie Joiner, LMT
• Shauna M Jones, MSN, APRN, FNP-C
• Jrda Holdings, LLC
• Kristin Kali Kaufmann, M.S., CCC-SLP
• Nastassia Mae Keel, MSN, APRN, FNP-C
• Camille Plasek Koehler, PTA
• Amy Kyle, PT
• Teresa Ann Laseter, LCSW
• Terry Lassiter, D.D.S.
• Loretta Bryce Lee, M.S., CCC-SLP

• Pharmacist in Hewitt, TX
• Providers in Hewitt, TX by specialty
• Pharmacist in Texas

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