Individual provider Active NPI

Jennifer Lynn Wilborn, CRNA

  • Certified Registered Nurse Anesthetist
  • Boaz, AL
National Provider Identifier
1417942830
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-076095 Issued in AL
Practice address
2505 US Highway 431
MMCS Anesthesia
Boaz, AL 35957-5908
Phone
(256) 840-3512
NPI assigned
Sep 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-076095 AL Primary

Addresses

Primary practice location

2505 US Highway 431
MMCS Anesthesia
Boaz, AL 35957-5908

Mailing address

2580 Bruce Rd
Boaz, AL 35957-5063
Phone (256) 593-7614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111027000936 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749453231 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Payne Anesthesia Services LLCGroup PAC ID 5496268559, 18 clinicians
Marshall Medical Center SouthGroup PAC ID 0648534495, 43 clinicians

Practice addresses (Care Compare)

200 Medical Ctr Dr SW
Fort Payne, AL 35968-3458
Phone (256) 845-3150

2505 US Hwy 431
Boaz, AL 35957-5908
Phone (256) 593-8310

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Payne Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 15, 2025 Accepting new patients
Hospitalist Medicine Physicians of Alabama-TCS Inc Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2021 Accepting new patients
360 Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2023 Accepting new patients
Marshall Medical Center South Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2018 Accepting new patients
HH Health System - Marshall LLC Current Accepting new patients

Locations

2505 US Highway 431
Boaz, AL 35957
Phone (256) 506-0061

2505 US Highway 431
Ste 104
Boaz, AL 35957

200 Medical Center Dr SW
Fort Payne, AL 35968
Phone (256) 845-3150

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417942830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 BRUCE RD",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359575063",
            "telephone_number": "256-593-7614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 US HIGHWAY 431",
            "address_2": "MMCS ANESTHESIA",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359575908",
            "telephone_number": "256-840-3512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBORN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-076095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boaz, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.