Myrissa L Thomas, FNP
Individual provider Active NPI Family Nurse Practitioner · Gunnison, UT
NPI 1871360149 · NPPES record last updated Jul 15, 2025
Key facts
- NPI
- 1871360149
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 11295565-4405 (UT)
- Practice address
- 95 E Center St
Gunnison, UT 84634-7770 - Phone
- (435) 528-7227
- Fax
- (435) 528-2175
- NPI assigned
- Dec 7, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Revere Health PC
Practice addresses (Care Compare)
95 E Ctr St
Gunnison, UT 84634-7770
Phone (435) 528-7227
Hospital & facility affiliations
- Gunnison Valley Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250811001670 | UT | Practitioner - Nurse Practitioner | 5092213926 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11295565-4405 | UT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revere Health PC | Current |
Accepting new patients | |
| Revere Health PC | Current |
Accepting new patients |
Locations
191 S Main St
Ste 1
Ephraim, UT 84627
Phone (801) 655-5490
1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000
Interoperability endpoints
- myrissathomas@cuccu.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 11295565-4405 | UT | Yes |
Addresses
Primary practice location
95 E Center St
Gunnison, UT 84634-7770
Mailing address
1055 N 500 W
Att Credentialing
Provo, UT 84604-3305
Phone (801) 354-8225
Other practice location 1
162 E 100 S
Gunnison, UT 84634-0996
Phone (435) 558-0320
Other names
- Myrissa L Gossard
Other providers in Gunnison, UT
- Alyssia Stevenson
- Kathryn Taylor
- Teen Discovery Home
- Therapy West LLC
- Therapy West Rehab Agency LLC
- Brian Thompson
- Amie Sue Tucker
- Willard Ray Tucker
- Amy Vanderherp
- Gerald J Willden
All providers in Gunnison, UT · Family Nurse Practitioner in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.