Individual provider Active NPI

Susan Wigetman, CRNA

  • Certified Registered Nurse Anesthetist
  • Sierra Vista, AZ
National Provider Identifier
1487979977
Registry record updated Oct 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN2263101 Issued in MA
Practice address
77 Calle Portal Ste B260
Sierra Vista, AZ 85635-2982
Phone
(520) 226-4338
NPI assigned
Mar 29, 2010
Last updated
Oct 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN2263101 MA Primary
Certified Registered Nurse Anesthetist 367500000X 203923 ND
Certified Registered Nurse Anesthetist 367500000X 2026018680 MO

Addresses

Primary practice location

77 Calle Portal Ste B260
Sierra Vista, AZ 85635-2982

Mailing address

77 Calle Portal Ste B260
Sierra Vista, AZ 85635-2982
Phone (520) 226-4338

Other practice location 1

1 Hospital Dr
Columbia, MO 65212-1000
Phone (573) 882-2568

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WY, IL, TX, FL, SD6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20140923002259 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052441623
I20201009000790 WY Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052441623 Reassigns benefits to 1 organization
I20220301000320 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052441623 Reassigns benefits to 1 organization
I20220625000325 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052441623 Reassigns benefits to 1 organization
I20250729004649 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052441623 Reassigns benefits to 1 organization
I20260130001586 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052441623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera St MarysGroup PAC ID 0143134965, 97 clinicians

Practice addresses (Care Compare)

1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone (954) 939-5000

801 E Sioux Ave
Pierre, SD 57501-3323
Phone (605) 224-5901

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
203923NDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Anesthesiologists, SC CurrentSince Jan 14, 2022 Accepting new patients
Campbell County Hospital District CurrentSince Oct 12, 2020 Accepting new patients
Avera St Marys Nurse Anesthetist, Certified Registered CurrentSince Dec 29, 2025 Accepting new patients
Associated Anesthesiologists, S.C. CurrentSince Jan 14, 2022 Accepting new patients
Anesthesiology Associates of Tallahassee Inc Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2025 Accepting new patients
Campbell County Hospital District Current Accepting new patients
Hendrick Anesthesia Network CurrentSince May 30, 2022 Accepting new patients
Campbell County Hospital District Current Accepting new patients
Anesthesiology Associates of Tallahassee Inc Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2025 Accepting new patients
Campbell County Hospital District CurrentSince Oct 12, 2020 Accepting new patients
Central Mass Anesthesia Affiliates Inc. Past Accepting new patients
Anesthesiology Associates of Tallahassee Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Sierra Vista Pathology PC Past Accepting new patients

Locations

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

2173 Centerville Pl
Ste A
Tallahassee, FL 32308

2626 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 325-5000

2629 Welaunee Blvd
Tallahassee, FL 32308
Phone (850) 877-4688

530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393

6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393

1900 Pine St
Abilene, TX 79601
Phone (325) 670-4220

6250 US Highway 83
Abilene, TX 79606
Phone (325) 428-3900

751 N 18th St
Abilene, TX 79601
Phone (915) 676-0557

501 S Burma Ave
Gillette, WY 82716
Phone (307) 682-8811

Organizations & group practices 14

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 14

Hospital & facility affiliations 4

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": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791849600000",
    "number": "1487979977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 CALLE PORTAL STE B260",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352982",
            "telephone_number": "520-226-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CALLE PORTAL STE B260",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352982",
            "telephone_number": "520-226-4338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652121000",
            "country_code": "US",
            "telephone_number": "573-882-2568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIGETMAN",
        "first_name": "SUSAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-29",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN2263101",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "203923",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2026018680",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

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