Individual provider Active NPI

Laura S. Blanks, CRNA

  • Certified Registered Nurse Anesthetist
  • Biloxi, MS
National Provider Identifier
1306192612
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
900242 Issued in MS
Practice address
301 Fisher St
Biloxi, MS 39534-2508
Phone
(228) 376-6018
NPI assigned
Jul 24, 2012
Last updated
Apr 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 900242 MS Primary
Certified Registered Nurse Anesthetist 367500000X 18260 WI

Addresses

Primary practice location

301 Fisher St
Biloxi, MS 39534-2508

Mailing address

301 Fisher St
Biloxi, MS 39534-2508
Phone (228) 376-6018

Other practice location 1

2938 Juliette Dr
Ocean Springs, MS 39564-5542
Phone (715) 864-9733

Other practice location 2

415 S 28th Ave
Hattiesburg, MS 39401-7246
Phone (601) 261-3606

Other practice location 3

2116 Craig Rd
Eau Claire, WI 54701-6118
Phone (715) 858-4500

Other practice location 4

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Other identifiers 1

IdentifierTypeStateIssuer
04854078MedicaidMS

Other names 1

  • Ms. Laura S Wildenberg Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lwildenberg48601@directpatientrecord.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150804005432 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507170578 Reassigns benefits to 8 organizations
I20250424002053 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507170578 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCHS Hospitals IncGroup PAC ID 5698071173, shared by 28 NPIs, 1,195 clinicians
Singing River GulfportGroup PAC ID 5294154829, shared by 3 NPIs, 75 clinicians
Singing River Health SystemGroup PAC ID 3870405194, shared by 10 NPIs, 290 clinicians

Practice addresses (Care Compare)

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

15200 Community Rd
Gulfport, MS 39503-3085
Phone (228) 575-7000

1700 W Stout St
Rice Lake, WI 54868-5000
Phone (715) 236-6133

2310 Craig Rd
Eau Claire, WI 54701-6128
Phone (715) 858-8100

2809 Denny Ave
Pascagoula, MS 39581-5301
Phone (228) 809-5000

3109 Bienville Blvd
Ocean Springs, MS 39564-4361
Phone (228) 818-1111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
900242MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Health System CurrentSince Feb 17, 2021 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince May 5, 2025 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Hogan Surgical Center PA CurrentSince May 1, 2022 Accepting new patients
Flambeau Hospital Inc CurrentSince May 5, 2025 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince May 5, 2025 Accepting new patients
Memorial Hospital Inc CurrentSince May 5, 2025 Accepting new patients
Hogan Surgical Center, P. a. - Crna Services Nurse Anesthetist, Certified Registered CurrentSince May 1, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince May 5, 2025 Accepting new patients
Champion Anesthesia Consultants, PLLC CurrentSince Nov 1, 2024 Accepting new patients
Flambeau Hospital Inc CurrentSince May 5, 2025 Accepting new patients
Singing River Health System CurrentSince Oct 1, 2022 Accepting new patients
Singing River Gulfport CurrentSince Jan 1, 2023 Accepting new patients
Singing River Gulfport CurrentSince Aug 1, 2021 Accepting new patients
Jackson County Anesthesia CurrentSince Jun 1, 2022 Accepting new patients
Marshfield Clinic Inc CurrentSince May 5, 2025 Accepting new patients
MCHS Hospitals Inc CurrentSince May 5, 2025 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince May 5, 2025 Accepting new patients

Locations

2101 Highway 90
Gautier, MS 39553
Phone (228) 497-7576

15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000

350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054

351 Cowan Rd
Gulfport, MS 39507
Phone (228) 896-1120

3109 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 818-1100

2406 Catalpa Ave
Pascagoula, MS 39567
Phone (228) 202-1006

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

2116 Craig Rd
Eau Claire, WI 54701
Phone (715) 858-4500

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 2

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": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1306192612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 FISHER ST",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395342508",
            "telephone_number": "228-376-6018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 FISHER ST",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395342508",
            "telephone_number": "228-376-6018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2938 Juliette Dr",
            "address_purpose": "LOCATION",
            "city": "Ocean Springs",
            "state": "MS",
            "postal_code": "395645542",
            "country_code": "US",
            "telephone_number": "715-864-9733",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415 S 28th Ave",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394017246",
            "country_code": "US",
            "telephone_number": "601-261-3606",
            "fax_number": "601-579-5240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2116 Craig Rd",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547016118",
            "country_code": "US",
            "telephone_number": "715-858-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 N Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "WI",
            "postal_code": "544495703",
            "country_code": "US",
            "telephone_number": "715-387-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANKS",
        "first_name": "LAURA",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "900242",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "18260",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04854078",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwildenberg48601@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "415 S 28th Ave",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394017246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "WILDENBERG",
            "middle_name": "S",
            "prefix": "MS.",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Biloxi, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.