Individual provider Active NPI

Lisa Speaks Wiggins, CRNA

  • Certified Registered Nurse Anesthetist
  • Monroe, NC
National Provider Identifier
1730265372
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
048600 Issued in NC
Practice address
600 Hospital Dr
Monroe, NC 28112-6000
Phone
(704) 283-3179
Fax
(704) 226-5800
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 048600 NC Primary

Addresses

Primary practice location

600 Hospital Dr
Monroe, NC 28112-6000

Mailing address

600 Hospital Dr
Monroe, NC 28112-6000
Phone (704) 283-3179

Other identifiers 2

IdentifierTypeStateIssuer
8050986MedicaidNC
NAN265MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041124000148 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608831128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Onslow Memorial Hospital IncGroup PAC ID 1456252899, 65 clinicians

Practice addresses (Care Compare)

317 Western Boulevard
Jacksonville, NC 28546-6338
Phone (910) 577-2345

Hospital & facility affiliations

  • Onslow Memorial Hospital Hospital, Jacksonville, NC, CCN 340042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
048600NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Onslow Memorial Hospital Inc CurrentSince Nov 3, 2008 Accepting new patients
Onslow Memorial Hospital, Inc. CurrentSince Nov 3, 2008 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Past Accepting new patients
The Presbyterian Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

241 New River Dr
Jacksonville, NC 28540
Phone (910) 430-4152

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

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 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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730265372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HOSPITAL DR",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281126000",
            "telephone_number": "704-283-3179",
            "fax_number": "704-226-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HOSPITAL DR",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281126000",
            "telephone_number": "704-283-3179",
            "fax_number": "704-226-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "LISA",
        "middle_name": "SPEAKS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "048600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8050986",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NAN265",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.