Individual provider Active NPI

Mary Boers, CRNA

  • Certified Registered Nurse Anesthetist
  • Memphis, TN
National Provider Identifier
1487814133
Registry record updated Oct 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
112814 Issued in TN
Practice address
1755 Kirby Pkwy
Suite 330
Memphis, TN 38120
Phone
(901) 725-5846
Fax
(901) 726-4827
NPI assigned
Jun 16, 2008
Last updated
Oct 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 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 43-558354 KS
Certified Registered Nurse Anesthetist 367500000X 112814 TN Primary

Addresses

Primary practice location

1755 Kirby Pkwy
Suite 330
Memphis, TN 38120

Mailing address

PO Box 171306
Memphis, TN 38187-1306
Phone (800) 809-2106

Other practice location 1

500 E Thorpe St
Lakin, KS 67860-9625
Phone (620) 355-7550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS, KS3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20081224000215 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698837763 Reassigns benefits to 1 organization
I20130925000121 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698837763 Reassigns benefits to 1 organization
I20251209001682 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698837763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelinc Anesthesia PLLCGroup PAC ID 0941347447, 169 clinicians
Lifelinc Anesthesia VIII PLLCGroup PAC ID 3173984762, 155 clinicians

Practice addresses (Care Compare)

7600 Airways Blvd
Suite D
Southaven, MS 38671-5138
Phone (662) 548-2190

825 Ridge Lake Blvd
Memphis, TN 38120-9411
Phone (901) 685-2200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13702TNMDClinical Social Worker
112814TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Kearny County Hospital CurrentSince Feb 1, 2026 Accepting new patients
Lifelinc Anesthesia VIII PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 11, 2025 Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 24, 2026 Accepting new patients
Kearny County Hospital CurrentSince Feb 1, 2026 Accepting new patients

Locations

500 E Thorpe St
Lakin, KS 67860
Phone (620) 355-7111

6947 Crumpler Blvd
Ste 105
Olive Branch, MS 38654
Phone (662) 893-3306

7600 Airways Blvd
Ste D
Southaven, MS 38671
Phone (662) 349-7477

825 Ridge Lake Blvd
Memphis, TN 38120
Phone (901) 685-6150

435 2nd St
Newport, TN 37821
Phone (423) 625-2200

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/554843c8-8d71-4199-8499-511dff49069d/

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1487814133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 171306",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381871306",
            "telephone_number": "800-809-2106",
            "fax_number": "334-386-2037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 KIRBY PKWY",
            "address_2": "SUITE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38120",
            "telephone_number": "901-725-5846",
            "fax_number": "901-726-4827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 E Thorpe St",
            "address_purpose": "LOCATION",
            "city": "Lakin",
            "state": "KS",
            "postal_code": "678609625",
            "country_code": "US",
            "telephone_number": "620-355-7550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOERS",
        "first_name": "MARY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "43-558354",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "112814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.