Marissa Christine Myres, APRN,CNS

Primary specialty

Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X

License

209012031 Issued in IL

Practice address

3308 W Chartwell Rd
Peoria, IL 61614-2322

Phone

(309) 691-7640

Fax

(309) 691-7643

NPI assigned

Oct 16, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
• St Mary Medical Center Hospital, Galesburg, IL, CCN 140064
• Osf Saint Clare Medical Center Hospital, Princeton, IL, CCN 141337
• Graham Hospital Association Hospital, Canton, IL, CCN 140001
• Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Nurse Practitioner

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 and National Provider Directory roles.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Cardinal Medical Group, LTD.

  • Multi-Specialty Clinic/Center
  • Peoria, IL
  • NPI 1992829485
  NPD (past)
• Osf Multispecialty Group - Eastern Region, LLC

  dba OSF Medical Group - College Avenue

  • Internal Medicine Physician
  • Bloomington, IL
  • NPI 1487881058
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Osf Healthcare System

  dba OSF Saint Clare Medical Center

  • Critical Access Hospital
  • Princeton, IL
  • NPI 1093308439
  Care Compare affiliation
• Ottawa Regional Hospital & Healthcare Center

  dba OSF Saint Elizabeth Medical Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440
  Care Compare affiliation
• St Mary Medical Center

  dba OSF Saint Mary Medical Center

  • General Acute Care Hospital
  • Galesburg, IL
  • NPI 1164485363
  Care Compare affiliation

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

{
    "created_epoch": "1413417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1073917258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3308 W CHARTWELL RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142322",
            "telephone_number": "309-691-7640",
            "fax_number": "309-691-7643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3308 W CHARTWELL RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142322",
            "telephone_number": "309-691-7640",
            "fax_number": "309-691-7643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYRES",
        "first_name": "MARISSA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "APRN,CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-16",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.385496",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "IL",
            "license": "209.012031",
            "primary": false
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "IL",
            "license": "209012031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew John Myers, MPT
• Miranda Myers, LCSW
• Rachel Myers, NP
• Robert Thompson Myers, M.D.
• Thomas Frank Myers, RN
• Rahmat O NA'Allah, M.D.
• Daniah Nacarato, APN
• Meghana Nadiger, M.D.
• Margaret Besler Nagel, M.D.
• Gurramkonda Naidu, M.D.

• Gerontology Clinical Nurse Specialist in Peoria, IL
• Providers in Peoria, IL by specialty
• Gerontology Clinical Nurse Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.