Organization Active NPI

Thrive Healthcare Center L L C

  • Family Nurse Practitioner
  • Olney, IL
National Provider Identifier
1477368942
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
THRIVE HEALTHCARE CENTER L L C
Practice address
405 S Whittle Ave
Olney, IL 62450-2262
Phone
(618) 838-0176
NPI assigned
Feb 11, 2025
Last updated
Mar 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Authorized official

Name
Marlissa Boyles, NPNPI 1316314933
Title
Nurse Practitioner
Phone
(618) 838-0176

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

405 S Whittle Ave
Olney, IL 62450-2262

Mailing address

405 S Whittle Ave
Olney, IL 62450-2262
Phone (618) 838-0176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250311000627 IL Part B Supplier - Clinic/Group Practice 2365963030 Receives reassigned benefits from 1 practitioner
Practice locations: Olney, IL; Robinson, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2326025Thrive Healthcare Center405 S Whittle Ave, Olney, IL 62450Certificate of waiverJun 24, 2027

National Provider Directory

National Provider Directory

Locations

102 Douglas St
Robinson, IL 62454
Phone (618) 838-0176

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1477368942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S WHITTLE AVE",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624502262",
            "telephone_number": "618-838-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S WHITTLE AVE",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624502262",
            "telephone_number": "618-838-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE HEALTHCARE CENTER L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "BOYLES",
        "authorized_official_first_name": "MARLISSA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "618-838-0176",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.