Individual provider Active NPI

James Myers, ACNPC-AG

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1205478906
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
277003483 Issued in IL
Practice address
676 N Saint Clair St Ste 14-044
Chicago, IL 60611-2927
Phone
(312) 908-8163
Fax
(312) 695-1394
NPI assigned
Oct 14, 2019
Last updated
Dec 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP143494 TX
Nurse Practitioner 363L00000X 277003483 IL Primary

Addresses

Primary practice location

676 N Saint Clair St Ste 14-044
Chicago, IL 60611-2927

Mailing address

676 N Saint Clair St Ste 14-044
Chicago, IL 60611-2927
Phone (312) 908-8163

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20200203000662 TX Practitioner - Nurse Practitioner 7618303074 Reassigns benefits to 2 organizations
I20241107000986 IL Practitioner - Nurse Practitioner 7618303074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Texas Tech University Health Science Center School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
277003483ILMDNurse Practitioner
AP143494TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Family of Doctors CurrentSince Aug 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 31, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 31, 2024 Accepting new patients
Seton Family of Doctors CurrentSince Aug 1, 2022 Accepting new patients
Ipc Healthcare Services of Texas, PLLC Nurse Practitioner CurrentSince Feb 1, 2020 Accepting new patients
Central Dupage Physician Group PastSince Dec 15, 2024 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

676 N Saint Clair St
Ste 14044
Chicago, IL 60611
Phone (312) 695-2003

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1205478906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 14-044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112927",
            "telephone_number": "312-908-8163",
            "fax_number": "312-695-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 14-044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112927",
            "telephone_number": "312-908-8163",
            "fax_number": "312-695-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "JAMES",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-14",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP143494",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "277003483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.