Individual provider Active NPI

Kristen K Pembroke, CRNA

  • Certified Registered Nurse Anesthetist
  • Memphis, TN
National Provider Identifier
1770758450
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN13511 Issued in TN
Practice address
877 Jefferson Ave
Memphis, TN 38103-2807
Phone
(901) 448-5893
Fax
(901) 448-5540
NPI assigned
Apr 24, 2008
Last updated
Feb 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 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 95002287 CA
Certified Registered Nurse Anesthetist 367500000X 901380 MS
Certified Registered Nurse Anesthetist 367500000X APN13511 TN Primary

Addresses

Primary practice location

877 Jefferson Ave
Memphis, TN 38103-2807

Mailing address

877 Jefferson Ave
Attn: Provider Enrollment
Memphis, TN 38103-2807
Phone (901) 545-7302

Other practice location 1

7900 Airways Blvd Ste 101
Southaven, MS 38671-4113
Phone (662) 349-6950

Other practice location 2

8000 Wolf River Blvd Ste 200
Germantown, TN 38138-1755
Phone (901) 747-3630

Other identifiers 1

IdentifierTypeStateIssuer
1505838MedicaidTN

Other names 1

  • Kristen Kail Gibson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS, CA, AR, KS5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20080714000192 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466524152 Reassigns benefits to 5 organizations
I20160806000007 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466524152 Reassigns benefits to 3 organizations
I20250211003082 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466524152 Reassigns benefits to 1 organization
I20250717002176 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466524152 Reassigns benefits to 1 organization
I20250924000699 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466524152 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
Excelle Anesthesia Services IncGroup PAC ID 4688046774, 41 clinicians
Medical Anesthesia Group, PAGroup PAC ID 9436047685, 42 clinicians
East Memphis Anesthesia Services PLCGroup PAC ID 1850386038, 26 clinicians
Gastroenterology Center of the Midsouth PLLCGroup PAC ID 4880619824, 148 clinicians

Practice addresses (Care Compare)

2215 Truxtun Ave
Bakersfield, CA 93301-3602
Phone (661) 632-5504

4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (662) 932-9000

7600 Airways Blvd
Suite F
Southaven, MS 38671-5138
Phone (901) 685-2200

7900 Airways Blvd
Southaven, MS 38671-4113
Phone (662) 349-6950

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
85.75 of 100Reported as group
Quality
83.24
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13511TNMDLicensed Practical Nurse
95002287CAMDCertified Registered Nurse Anesthetist
APN13511TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Regional One Physicians Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Premier Anesthesia of Washington, PC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2025 Accepting new patients
Gastroenterology Center of the Midsouth PLLC Nurse Anesthetist, Certified Registered CurrentSince May 15, 2012 Accepting new patients
Medical Anesthesia Group, PA CurrentSince Oct 27, 2014 Accepting new patients
Excelle Anesthesia Services, Inc. CurrentSince Jan 1, 2025 Accepting new patients
G I Diagnostic and Therapeutic Center LLC Current Accepting new patients
Phillip R. Bowden, M.D.,P.a. CurrentSince Aug 1, 2010 Accepting new patients
Premier Anesthesia of Arkansas Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince Jul 15, 2025 Accepting new patients
Health 360 PLLC PastSince Jan 21, 2024 Accepting new patients

Locations

3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1000

2215 Truxtun Ave
Bakersfield, CA 93301
Phone (661) 477-9283

2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804

400 S Santa Fe Ave
Salina, KS 67401
Phone (785) 452-6019

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

7580 Clarington Cv
Southaven, MS 38671
Phone (901) 259-1600

7668 Airways Blvd
Bldg 2
Southaven, MS 38671
Phone (901) 766-9490

7900 Airways Blvd
Bldg B100
Southaven, MS 38671
Phone (662) 349-2442

589 Garfield St
Ste 201
Tupelo, MS 38801
Phone (662) 680-5565

Gastro Onegovt Arhcl
New York, NY 10087

1310 Wolf Park Dr
Germantown, TN 38138
Phone (901) 624-5151

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1325 Eastmoreland Ave
Ste 410
Memphis, TN 38104
Phone (901) 261-6650

1363 S Germantown Rd
Memphis, TN 38138
Phone (901) 516-6000

1717 Kirby Pkwy
Memphis, TN 38120
Phone (901) 272-7200

255 S Pauline St
Memphis, TN 38104
Phone (901) 261-2804

6060 E Primacy Pkwy
Ste 241
Memphis, TN 38119
Phone (901) 725-5846

8000 Wolf River Blvd
Ste 200
Memphis, TN 38138
Phone (901) 684-5503

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

Organizations & group practices 10

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.

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": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1770758450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "address_2": "ATTN: PROVIDER ENROLLMENT",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807",
            "telephone_number": "901-545-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807",
            "telephone_number": "901-448-5893",
            "fax_number": "901-448-5540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7900 Airways Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386714113",
            "country_code": "US",
            "telephone_number": "662-349-6950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8000 Wolf River Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381381755",
            "country_code": "US",
            "telephone_number": "901-747-3630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEMBROKE",
        "first_name": "KRISTEN",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95002287",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "901380",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN13511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1505838",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "GIBSON",
            "middle_name": "KAIL",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Feb 10, 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.