NPIMap

Individual provider Active NPI

Charissa Gardner Myers, M.D.

  • Family Medicine Physician
  • King of Prussia, PA
National Provider Identifier
1083875231
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD441169 Issued in PA
Practice address
700 S Henderson Rd Ste 306
King of Prussia, PA 19406-4208
Phone
(610) 265-0726
Fax
(601) 265-3132
NPI assigned
Jun 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD441169 PA Primary

Addresses

Primary practice location

700 S Henderson Rd Ste 306
King of Prussia, PA 19406-4208

Mailing address

700 S Henderson Rd Ste 306
King of Prussia, PA 19406-4208
Phone (610) 265-0726

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110622000310 PA Practitioner - Family Practice 4486832409 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fornance Physician Services IncGroup PAC ID 8527962661, 105 clinicians

Practice addresses (Care Compare)

210 Mall Blvd
Suite 102
King of Prussia, PA 19406-3260
Phone (610) 265-0726

Hospital & facility affiliations

  • Jefferson Health at Home by Bayada Home health agency, Horsham, PA, CCN 397145
  • Jefferson Einstein Montgomery Hospital Hospital, East Norriton, PA, CCN 390329
  • Jefferson Einstein Philadelphia Hospital Hospital, Philadelphia, PA, CCN 390142
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD441169PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fornance Physician Services, Inc Family Medicine CurrentSince Jul 1, 2011 Accepting new patients
Fornance Physician Services, Inc. CurrentSince Jul 1, 2011 Accepting new patients
Einstein Community Health Associates, Inc Family Medicine CurrentSince Jan 1, 2026 Accepting new patients
Einstein Community Health Associates, Inc CurrentSince Jan 1, 2026 Accepting new patients
Fornance Physician Services, Inc Current Accepting new patients

Locations

612 Fayette St
Fl 2
Conshohocken, PA 19428
Phone (484) 622-6500

700 S Henderson Rd
Ste 306
Kng of Prussa, PA 19406
Phone (484) 685-3933

210 Mall Blvd
Ste 102
Kng of Prussa, PA 19406
Phone (610) 265-0726

5501 York Rd
Ste 202
Philadelphia, PA 19141
Phone (215) 254-2630

101 E Olney Ave
Ste C5
Philadelphia, PA 19120
Phone (215) 927-1937

Interoperability endpoints

  • Direct secure messaging: charissa.myers@direct.einstein.edu

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1083875231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S HENDERSON RD STE 306",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194064208",
            "telephone_number": "610-265-0726",
            "fax_number": "601-265-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S HENDERSON RD STE 306",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194064208",
            "telephone_number": "610-265-0726",
            "fax_number": "601-265-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "CHARISSA",
        "middle_name": "GARDNER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD441169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

Verify at the official NPI Registry.