Individual provider Active NPI

Amy Cyrus, ANP-BC

  • Family Nurse Practitioner
  • Belleville, IL
National Provider Identifier
1154723229
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.012867 Issued in IL
Practice address
12 N 64TH St
Belleville, IL 62223-3809
Phone
(618) 877-4420
NPI assigned
Sep 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704312611 MI
Family Nurse Practitioner 363LF0000X 209.012867 IL Primary

Addresses

Primary practice location

12 N 64TH St
Belleville, IL 62223-3809

Mailing address

448 Wylie Dr Ste 100
Normal, IL 61761-5405
Phone (618) 512-1803

Other practice location 1

220 East Third St.
Perry, MI 48872
Phone (734) 926-4800

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220531002632 IL Practitioner - Nurse Practitioner 0547658924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Chestnut Health Systems IncGroup PAC ID 1052393063, 31 clinicians

Practice addresses (Care Compare)

12 N 64TH St
Belleville, IL 62223-3809
Phone (618) 397-0900

50 Northgate Industrial Dr
Granite City, IL 62040-6805
Phone (618) 877-4420

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704312611MIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chestnut Health Systems Inc CurrentSince Feb 11, 2022 Accepting new patients
Chestnut Health Systems Inc. CurrentSince Feb 11, 2022 Accepting new patients
Chestnut Health Systems, Inc Past Accepting new patients

Locations

12 N 64th St
Belleville, IL 62223
Phone (618) 397-0900

720 W Chestnut St
Bloomington, IL 61701
Phone (309) 557-1400

702 W Chestnut St
Bloomington, IL 61701
Phone (309) 557-1400

1003 Martin Luther King Dr
Bloomington, IL 61701
Phone (309) 827-6026

50 Northgate Industrial Dr
Granite City, IL 62040
Phone (618) 512-1919

2148 Vadalabene Dr
Maryville, IL 62062
Phone (618) 288-3100

448 Wylie Dr
Ste 100
Normal, IL 61761

448 Wylie Dr
Normal, IL 61761
Phone (844) 973-6887

102 4th St
Hillsboro, MO 63050
Phone (636) 638-2618

Organizations & group practices 7

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": "1411171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1154723229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 WYLIE DR STE 100",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617615405",
            "telephone_number": "618-512-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N 64TH ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622233809",
            "telephone_number": "618-877-4420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 East Third St.",
            "address_purpose": "LOCATION",
            "city": "Perry",
            "state": "MI",
            "postal_code": "48872",
            "country_code": "US",
            "telephone_number": "734-926-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CYRUS",
        "first_name": "AMY",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-20",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704312611",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.012867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.