Individual provider Active NPI

Karene Antonette Myers, RPH, PHARMD, BS

  • Pharmacist
  • Peoria, IL
National Provider Identifier
1720323025
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051291632 Issued in IL
Practice address
1200 W Main St
Peoria, IL 61606-1200
Phone
(309) 673-6272
NPI assigned
Nov 28, 2012
Last updated
Jan 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051291632 IL Primary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 051291632 IL
Geriatric Pharmacist 1835G0303X 051291632 IL
Oncology Pharmacist 1835X0200X 051291632 IL

Addresses

Primary practice location

1200 W Main St
Peoria, IL 61606-1200

Mailing address

5420 W Haymeadow LN
Apt 3a
Peoria, IL 61615-3152
Phone (309) 966-4274

Other practice location 1

4125 N Sheridan Rd
Peoria, IL 61614-7167
Phone (309) 686-7058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science, Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051291632ILMDGeriatric Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Park CVS, L.L.C. PastSince Jan 8, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1720323025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 W HAYMEADOW LN",
            "address_2": "APT 3A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616153152",
            "telephone_number": "309-966-4274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W MAIN ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061200",
            "telephone_number": "309-673-6272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4125 N Sheridan Rd",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616147167",
            "country_code": "US",
            "telephone_number": "309-686-7058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "KARENE",
        "middle_name": "ANTONETTE",
        "name_prefix": "Dr.",
        "credential": "RPH, PHARMD, BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-28",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051291632",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IL",
            "license": "051291632",
            "primary": false
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "IL",
            "license": "051291632",
            "primary": false
        },
        {
            "code": "1835X0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Oncology",
            "state": "IL",
            "license": "051291632",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.