Individual provider Active NPI

Myrissa L Thomas, FNP

  • Family Nurse Practitioner
  • Gunnison, UT
National Provider Identifier
1871360149
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11295565-4405 Issued in UT
Practice address
95 E Center St
Gunnison, UT 84634-7770
Phone
(435) 528-7227
Fax
(435) 528-2175
NPI assigned
Dec 7, 2023
Last updated
Jul 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11295565-4405 UT Primary

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 1

  • Myrissa L Gossard Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250811001670 UT Practitioner - Nurse Practitioner 5092213926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revere Health PCGroup PAC ID 7517868508, 407 clinicians

Practice addresses (Care Compare)

95 E Ctr St
Gunnison, UT 84634-7770
Phone (435) 528-7227

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Sep 22, 2025 Accepting new patients
Revere Health PC CurrentSince Sep 22, 2025 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

  • Direct secure messaging: myrissathomas@cuccu.allscriptsdirect.net

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, 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": "1701907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1871360149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "ATT CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 E CENTER ST",
            "city": "GUNNISON",
            "state": "UT",
            "postal_code": "846347770",
            "telephone_number": "435-528-7227",
            "fax_number": "435-528-2175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "162 E 100 S",
            "address_purpose": "LOCATION",
            "city": "Gunnison",
            "state": "UT",
            "postal_code": "846340996",
            "country_code": "US",
            "telephone_number": "435-558-0320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MYRISSA",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-07",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11295565-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYRISSA",
            "last_name": "GOSSARD",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gunnison, UT

Sources for this page

Verify at the official NPI Registry.