Individual provider Active NPI

Lori Crystal Woullard-Breland, CRNA

  • Certified Registered Nurse Anesthetist
  • Hattiesburg, MS
National Provider Identifier
1467749754
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN9456859 Issued in FL
Practice address
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone
(601) 261-3606
Fax
(601) 579-5383
NPI assigned
Jul 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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 R859468 MS
Certified Registered Nurse Anesthetist 367500000X APRN9456859 FL Primary

Addresses

Primary practice location

415 S 28TH Ave
Hattiesburg, MS 39401-7246

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 579-5463

Other identifiers 4

IdentifierTypeStateIssuer
3476675OtherMSUNITED HEALTHCARE
9369843OtherMSAETNA
07527007MedicaidMS
6655503OtherMSCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, KY, IN, GA, AL, FL, SC7 enrollments

Enrollment records 7

Enrollment IDStateProvider typePAC IDDetails
I20120706000338 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284899733 Reassigns benefits to 2 organizations
I20140730000525 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284899733 Reassigns benefits to 1 organization
I20151125000027 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284899733 Reassigns benefits to 1 organization
I20171102002004 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284899733 Reassigns benefits to 3 organizations
I20180710000126 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284899733 Reassigns benefits to 3 organizations
I20200810001839 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284899733 Reassigns benefits to 2 organizations
I20250819003333 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284899733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams of Crestview LLCGroup PAC ID 5890944292, 22 clinicians
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians
Amsol Anesthetists of Georgia, LLCGroup PAC ID 5193780955, 26 clinicians

Practice addresses (Care Compare)

151 E Redstone Ave
Crestview, FL 32539-5352
Phone (850) 689-8100

3000 Saint Matthews Rd
Orangeburg, SC 29118-1442
Phone (803) 395-3400

4401 River Chase Dr
Phenix City, AL 36867-7483
Phone (334) 732-3010

Hospital & facility affiliations

  • North Okaloosa Medical Center Hospital, Crestview, FL, CCN 100122
  • Musc Medical Center Hospital, Charleston, SC, CCN 420004
  • Jack Hughston Memorial Hospital Hospital, Phenix City, AL, CCN 010168

Merit-based Incentive Payment System (MIPS)

Final score
73.64 of 100Reported as group
Quality
56.63
Improvement activities
40
Cost
74.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9456859FLMDCertified Registered Nurse Anesthetist
R859468MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians CurrentSince Jun 15, 2025 Accepting new patients
University of South Alabama Nurse Anesthetist, Certified Registered CurrentSince Mar 23, 2019 Accepting new patients
University of South Alabama Nurse Anesthetist, Certified Registered CurrentSince Mar 23, 2019 Accepting new patients
Ams of Crestview LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 13, 2025 Accepting new patients
Musc Community Physicians CurrentSince Jun 15, 2025 Accepting new patients
Amsol Anesthetists of Georgia, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 20, 2023 Accepting new patients
Hospitalist Medicine Physicians of Georgia - TCS, PC CurrentSince Mar 5, 2025 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Aug 27, 2024 Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 18, 2019 Accepting new patients
Epix Anesthesia of Alabama LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 5, 2018 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Aug 27, 2024 Accepting new patients
McComb Anesthesia Associates, LLP Nurse Anesthetist, Certified Registered CurrentSince Apr 7, 2018 Accepting new patients
St Claire Medical Center, Inc., Nurse Anesthetist, Certified Registered Current Accepting new patients
St Claire Medical Center, Inc CurrentSince Oct 13, 2020 Accepting new patients
Sentry Anesthesia Management, LLC CurrentSince Sep 5, 2023 Accepting new patients
St. Claire Medical Center Inc. Nurse Anesthetist, Certified Registered CurrentSince Oct 13, 2020 Accepting new patients
Amsol Anesthetists of Georgia LLC-Hughston Surgical Center Nurse Anesthetist, Certified Registered CurrentSince Mar 20, 2023 Accepting new patients
Montgomery Anesthesia Associates, PC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2018 Accepting new patients
Northstar Anesthesia of Indiana II, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 17, 2015 Accepting new patients

Locations

400 E 10th St
Anniston, AL 36207
Phone (256) 235-5121

2451 Fillingim St
Mobile, AL 36617
Phone (251) 434-3711

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

4401 Riverchase Dr
Phenix City, AL 36867
Phone (334) 732-3000

151 E Redstone Ave
Crestview, FL 32539
Phone (850) 629-8515

13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

100 Frist Ct
Columbus, GA 31909
Phone (706) 494-2100

6262 Veterans Pkwy
Columbus, GA 31909
Phone (706) 494-3071

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

1101 Michigan Ave
Logansport, IN 46947
Phone (574) 753-1475

222 Medical Cir
Morehead, KY 40351
Phone (606) 783-6455

634 Leigh Dr
Columbus, MS 39705
Phone (601) 978-3393

215 Marion Ave
McComb, MS 39648
Phone (601) 249-1180

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

3340 Players Club Pkwy
Ste 350
Memphis, TN 38125
Phone (901) 207-2017

Organizations & group practices 27

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.

View all 27

Hospital & facility affiliations 8

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": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1467749754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-579-5463",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-261-3606",
            "fax_number": "601-579-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOULLARD-BRELAND",
        "first_name": "LORI",
        "middle_name": "CRYSTAL",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-07",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R859468",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN9456859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3476675",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9369843",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07527007",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6655503",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.