Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Myranda Nicole Thomas

Individual provider Nurse Practitioner · NPI 1710676713

Myranda Nicole Thomas is a Nurse Practitioner in Carbondale, Illinois. Qualified in 2022, 4 years ago. Practices with Southern Illinois Medical Services Nfp, a 332-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
4
Licensed in
IL
In the registry since
2023
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Practice location Address checks out

2601 W Main St
Carbondale, IL 62901-1031
Phone: (618) 549-5361
Fax: (618) 351-4878
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 202 W Jackson St, Carbondale, IL 62901-1409 — (618) 457-3019

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 209026612 (IL)

Record details

NPI number1710676713
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 4, 2023
Last updated in NPPESMay 5, 2026
Certification dateMay 5, 2026
Mailing addressPo Box 3988, Carbondale, IL 62902-3988

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Southern Illinois Medical Services Nfp — 332 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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