Active NPI
Zachary Miers
- Nurse Practitioner
- Salt Lake City, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 14242940-4405
- Practice address
- 100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103 - Phone
- (801) 555-1212
- NPI assigned
- Jul 5, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Neonatal Nurse Practitioner | 363LN0005X | 209027805 | IL | |
| Nurse Practitioner | 363L00000X | 14242940-4405 | UT | Primary |
Addresses
Primary practice location
100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other practice location 1
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 655-2000
Other practice location 2
1859 Chantilly Ct # 506
Virginia Beach, VA 23451-6146
Phone (757) 771-5380
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC/ Office Ally |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230731003372 | IL | Practitioner - Nurse Practitioner | 0345601829 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14242940-4405 | UT | MD | Nurse Practitioner |
| 209027805 | IL | MD | Critical Care Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients |
Locations
2200 E Washington St
Bloomington, IL 61701
Phone (309) 662-3311
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762905600000",
"number": "1275211898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-555-1212"
}
],
"practiceLocations": [
{
"address_1": "530 NE Glen Oak Ave",
"address_purpose": "LOCATION",
"city": "Peoria",
"state": "IL",
"postal_code": "616370001",
"country_code": "US",
"telephone_number": "309-655-2000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1859 Chantilly Ct # 506",
"address_purpose": "LOCATION",
"city": "Virginia Beach",
"state": "VA",
"postal_code": "234516146",
"country_code": "US",
"telephone_number": "757-771-5380",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIERS",
"first_name": "ZACHARY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-05",
"last_updated": "2025-11-12",
"certification_date": "2025-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0005X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal, Critical Care",
"state": "IL",
"license": "209027805",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "UT",
"license": "14242940-4405",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.3",
"affiliationName": "Bluemark LLC/ Office Ally",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "1300 SE Cardinal Ct Ste 190",
"city": "Vancouver",
"state": "WA",
"country_code": "US",
"postal_code": "986839683",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.