CARISSA GORHAM
NPI 1407259559
Clinical Nurse Specialist in Peoria, IL

Q: What is Carissa Gorham's NPI number?

The NPI number for Carissa Gorham is 1407259559. It was assigned to this individual provider in the NPPES registry on October 3, 2014. The provider is also known as Carissa Myers.

Q: What is Carissa Gorham's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist with taxonomy code 364S00000X.

Q: When was this NPI record last updated?

The NPPES record for Carissa Gorham was last updated on October 3, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 03, 2014PECOS EnrolledAccepts Medicare Assignment

530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 655-3000 Get Directions Write a Review

NPPES record last updated: October 3, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Carissa Gorham NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARISSA GORHAM (NPI 1407259559) is an individual clinical nurse specialist in Peoria, Illinois, licensed in Illinois (041338732) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS, is affiliated with St Mary Medical Center, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1407259559

Entity TypeIndividualFemale

Primary Taxonomy364S00000X

Provider Legal NameCARISSA GORHAM

Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001

Mailing Address530 Ne Glen Oak AvePeoria, IL 61637-0001 · (309) 655-3000

Phone(309) 655-3000

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateOctober 3, 2014

✔ NPI 1407259559 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code364S00000X

License✔ Licensed in IL · 041338732

Definition

A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration.

530 NE GLEN OAK AVE, Peoria, IL 61637

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Other Names 1

Former Name (1)Carissa Myers

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Carissa Gorham is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8628391901

PECOS Enrollment IDI20141217000703

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

163 services94 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

92 services90 patients

Simple bladder irrigation and/or instillation 51700

Bladder irrigation and/or instillation is a process where a sterile solution is introduced into the bladder to cleanse it or deliver medication. This procedure helps manage certain bladder conditions, ensuring optimal bladder health.

29 services27 patients

Simple insertion of temporary bladder tube 51702

This procedure involves placing a temporary tube into your bladder to help with urine flow. It's done when the body can't naturally remove urine. The tube is inserted through a small opening and allows urine to drain into a bag. It's usually a short-term solution.

20 services19 patients

Complicated insertion of bladder tube 51703

This procedure involves placing a tube into your bladder to help with urine flow. It may be needed if you have trouble urinating naturally. The process requires specialized skill due to certain complexities but is done with utmost care for your comfort.

14 services14 patients

Simple change of bladder tube 51705

A simple change of bladder tube involves replacing your current urinary drainage tube with a new one. This is done to maintain hygiene and prevent infections. It's a straightforward process, usually causing minimal discomfort, and helps ensure your body can properly dispose of waste fluids.

13 services11 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Mary Medical Center

Acute Care Hospitals · Galesburg, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140064

Location3333 North SeminaryGalesburg, IL 61401 · Knox County

Emergency services Birthing friendly

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140067

Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County

Emergency services Birthing friendly

Osf Holy Family Medical Center

Critical Access Hospitals · Monmouth, IL

OwnershipVoluntary non-profit - Church

CMS Certification Number141318

Location1000 W Harlem AvenueMonmouth, IL 61462 · Warren County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61637 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DEEPAK S NAIR M.D.

Psychiatry & Neurology (Neurology)

530 NE GLEN OAK AVE
PEORIA, IL 61637

Peoria County (309) 655-2000

DR. HAMID MAHMOOD ZIA M.D

Pathology (Anatomic Pathology & Clinical Pathology)

530 NE GLEN OAK AVE, CENTRAL ILLINOIS PATHOLOGY SC
PEORIA, IL 61637

Peoria County (309) 624-9011

THOMAS JAMES MCMORROW MD

Pediatrics

530 NE GLEN OAK AVE
PEORIA, IL 61637

Peoria County (309) 655-2553

ALEXANDRA ROPER MD

Surgery

530 NE GLEN OAK AVE
PEORIA, IL 61637

Peoria County (309) 655-2000

JAPMEHR KAUR SANDHU M.B.B.S.

Student in an Organized Health Care Education/Training Program

530 NE GLEN OAK AVE
PEORIA, IL 61637

Peoria County (309) 624-9351

THOMAS BLACKWELL JR. MD

Student in an Organized Health Care Education/Training Program

530 NE GLEN OAK AVE
PEORIA, IL 61637

Peoria County (309) 655-2000

LUKE KLOFT

Student in an Organized Health Care Education/Training Program

530 NE GLEN OAK AVE
PEORIA, IL 61637

Peoria County (309) 655-2109

ABIGAIL V. WELU DO

Student in an Organized Health Care Education/Training Program

530 NE GLEN OAK AVE
PEORIA, IL 61637

Peoria County (309) 655-6710

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carissa Gorham's NPI number?

The NPI number for Carissa Gorham is 1407259559. It was assigned to this individual provider in the NPPES registry on October 3, 2014. The provider is also known as Carissa Myers.

Where is Carissa Gorham located?

Carissa Gorham practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (309) 655-3000.

What is Carissa Gorham's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist with taxonomy code 364S00000X.

Is Carissa Gorham enrolled in Medicare?

Yes. Carissa Gorham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Carissa Gorham affiliated with any hospitals?

According to CMS data, Carissa Gorham is affiliated with St Mary Medical Center, Saint Francis Medical Center and Osf Holy Family Medical Center.

When was this NPI record last updated?

The NPPES record for Carissa Gorham was last updated on October 3, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.