Individual provider Active NPI

Lisa Wilkerson

  • Certified Registered Nurse Anesthetist
  • Pascagoula, MS
National Provider Identifier
1366579047
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R815668 Issued in MS
Practice address
2809 Denny Ave
Pascagoula, MS 39581-5301
Phone
(228) 809-5000
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 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 117135-23 NH
Certified Registered Nurse Anesthetist 367500000X R815668 MS Primary

Addresses

Primary practice location

2809 Denny Ave
Pascagoula, MS 39581-5301

Mailing address

2101 Highway 90
Gautier, MS 39553-5340

Other practice location 1

1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

Other identifiers 3

IdentifierTypeStateIssuer
LW00114294MedicaidMS
430067914OtherRAILROAD MEDICARE
640942692OtherBLUE CROSS OF MS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AL, ID, ME, NH5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20101203000080 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860689890 Reassigns benefits to 7 organizations
I20191126001304 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860689890 Reassigns benefits to 1 organization
I20241118002732 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860689890 Reassigns benefits to 1 organization
I20250507000188 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860689890 Reassigns benefits to 1 organization
I20260507001053 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860689890 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians
Pain Consultants of Alabama, LLCGroup PAC ID 1355254756, 11 clinicians
Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

4105 Hospital St
Suite 112B
Pascagoula, MS 39581-5304
Phone (228) 938-0699

489 State St
Bangor, ME 04401-6616
Phone (207) 973-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
117135-23NHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince Jun 2, 2025 Accepting new patients
Pain Consultants of Alabama, LLC CurrentSince Jun 24, 2024 Accepting new patients
Pain Consultants of Alabama, LLC CurrentSince Jun 24, 2024 Accepting new patients
St Alphonsus Professional Medical Services LLC CurrentSince Aug 15, 2024 Accepting new patients
Singing River Gulfport CurrentSince Aug 10, 2021 Accepting new patients
Eastern Maine Medical Center CurrentSince Jun 2, 2025 Accepting new patients
Singing River Gulfport CurrentSince Jan 1, 2023 Accepting new patients
St Alphonsus Professional Medical Services LLC CurrentSince Aug 15, 2024 Accepting new patients
Singing River Health System CurrentSince Oct 1, 2022 Accepting new patients
Jackson County Anesthesia CurrentSince Aug 2, 2017 Accepting new patients
Singing River Gulfport CurrentSince Aug 10, 2021 Accepting new patients
Singing River Health System CurrentSince Jun 1, 2017 Accepting new patients
Champion Anesthesia Consultants, PLLC CurrentSince Nov 1, 2024 Accepting new patients
Coastal Anesthesia, P.C. CurrentSince Sep 5, 2019 Accepting new patients
Pain Consultants ASC LLC Past Accepting new patients

Locations

3610 Springhill Memorial Dr N
#D
Mobile, AL 36608
Phone (251) 342-3000

3610 Springhill Memorial Dr N
Mobile, AL 36608
Phone (251) 344-9630

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

489 State St
Bangor, ME 04401
Phone (207) 973-8837

1720B Medical Park Dr
Biloxi, MS 39532
Phone (228) 396-9161

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

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

4105 Hospital St
Ste 112A
Pascagoula, MS 39581
Phone (228) 938-0700

4105 Hospital St
Ste 112B
Pascagoula, MS 39581
Phone (228) 938-0699

Organizations & group practices 17

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 17

Hospital & facility affiliations 3

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1366579047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 HIGHWAY 90",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 DENNY AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815301",
            "telephone_number": "228-809-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037561000",
            "country_code": "US",
            "telephone_number": "603-650-5000",
            "fax_number": "603-640-1228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "LISA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "117135-23",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R815668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LW00114294",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430067914",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MS",
            "identifier": "640942692",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pascagoula, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.