Individual provider Active NPI

Gerthy Cipus Pierre

  • Psychiatric/Mental Health Nurse Practitioner
  • O Fallon, IL
National Provider Identifier
1083126353
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2023125387 Issued in IL
Practice address
9 Eagle Ctr Ste 3
O Fallon, IL 62269-1948
Phone
(618) 954-7434
Fax
(888) 533-1766
NPI assigned
Oct 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2013038384 MO
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 1014759 TX
Family Nurse Practitioner 363LF0000X 0192721 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2023125387 IL Primary

Addresses

Primary practice location

9 Eagle Ctr Ste 3
O Fallon, IL 62269-1948

Mailing address

1706 Cloverdale Dr
Edwardsville, IL 62025-5500
Phone (618) 954-7434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, OH, TX, AZ, MA, FL, MO7 enrollments
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 7

Enrollment IDStateProvider typePAC IDDetails
I20180423000520 IL Practitioner - Nurse Practitioner 8224391495 Reassigns benefits to 2 organizations
I20200924003376 OH Practitioner - Nurse Practitioner 8224391495 Reassigns benefits to 1 organization
I20210128000517 TX Practitioner - Nurse Practitioner 8224391495 Reassigns benefits to 2 organizations
I20220901003535 AZ Practitioner - Nurse Practitioner 8224391495
I20221213000186 MA Practitioner - Nurse Practitioner 8224391495 Reassigns benefits to 1 organization
I20240303000145 FL Practitioner - Nurse Practitioner 8224391495 Reassigns benefits to 2 organizations
I20240612004315 MO Practitioner - Nurse Practitioner 8224391495 Reassigns benefits to 2 organizations
Practice locations: Saint Louis, MO

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1706 Cloverdale Dr
Edwardsville, IL 62025-5500
Phone (847) 852-0145

24 E G H Washington St
Apopka, FL 32703-6318
Phone (847) 954-7434

8405 Almeda Genoa Rd
Suite U
Houston, TX 77075-2569
Phone (847) 954-7434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0192721ILMDFamily Nurse Practitioner
1014759TXMDFamily Nurse Practitioner
2023125387ILMDPsychiatric/Mental Health Nurse Practitioner
2013038384MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Locust Street Resource Center Multi-Specialty CurrentSince Mar 1, 2024 Accepting new patients
Caring Family Medical Clinic, LLC Multi-Specialty CurrentSince Jul 16, 2025 Accepting new patients
Southern Illinois Regional Wellness Center Multi-Specialty PastSince Mar 1, 2018 Accepting new patients

Locations

320 S Locust St
Carlinville, IL 62626
Phone (217) 854-3166

8405 Almeda Genoa Rd
Ste U
Houston, TX 77075
Phone (832) 317-7852

Organizations & group practices 6

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": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1083126353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 CLOVERDALE DR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620255500",
            "telephone_number": "618-954-7434",
            "fax_number": "888-533-1766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 EAGLE CTR STE 3",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691948",
            "telephone_number": "618-954-7434",
            "fax_number": "888-533-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIPUS PIERRE",
        "first_name": "GERTHY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-26",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2013038384",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1014759",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "0192721",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "2023125387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

Verify at the official NPI Registry.