John Carlton Myers, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

036095491 Issued in IL

Practice address

1340 Charles St Ste 300
Rockford, IL 61104-2200

Phone

(779) 696-8800

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24314/brand/2/csg/1/fhir/r4

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384128000000",
    "number": "1174553523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1567",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611100067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 CHARLES ST STE 300",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042200",
            "telephone_number": "779-696-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "JOHN",
        "middle_name": "CARLTON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2013-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036095491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32318300",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036095491",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beth Marie Mutton, LCPC,CADC,SAP
• Sophia Muzzarelli
• My First Words, Inc.
• My Massage Sanctuary, Inc
• Greg Myer, N.P
• Lance Avery Myers, D.C.
• Nicole Lynn Myers, LCPC
• Karyssa Myhres, BCBA
• Myofascial Therapy Center at Rockford, LLC
• Karin Myrvold, LPTA

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2013; 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.