Individual provider Active NPI

Lisa G Pearson, DNAP, CRNA, NSPMC

  • Interventional Pain Medicine Physician
  • Canon City, CO
National Provider Identifier
1790749604
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
APN.0015078-CRNA Issued in CO
Practice address
113 Latigo Lane
Suite D
Canon City, CO 81212-8115
Phone
(719) 371-0000
NPI assigned
Apr 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 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 RXA-100001 CO
Nurse Practitioner 363L00000X D148418 IA
Interventional Pain Medicine Physician 208VP0014X APN.0015078-CRNA CO Primary

Addresses

Primary practice location

113 Latigo Lane
Suite D
Canon City, CO 81212-8115

Mailing address

PO Box 388
Newton, KS 67114-0388
Phone (316) 281-3700

Other practice location 1

1338 Phay Ave
Canon City, CO 81212-2399
Phone (719) 285-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110913000666 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416847157 Reassigns benefits to 2 organizations
I20170928003234 IA Practitioner - Nurse Practitioner 7416847157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Metamorphosis LTDGroup PAC ID 1456573427, 5 clinicians

Practice addresses (Care Compare)

113 Latigo LN
Suite D
Canon City, CO 81212-8115
Phone (719) 371-0000

709 W Main St
Manchester, IA 52057-1526
Phone (563) 927-3232

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D148418IAMDNurse Practitioner
RXA-100001COMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metamorphosis Foundation CurrentSince Nov 18, 2025 Accepting new patients
Pikes Peak Physical Medicine, P.C. Past Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
Metamorphosis LTD Interventional Pain Medicine Past Accepting new patients
Anesthesia Services Medical Group of Topeka, PA Past Accepting new patients

Locations

113 Latigo Ln
Ste C
Canon City, CO 81212
Phone (719) 275-4896

6015 Lehman Dr
Ste 205
Colorado Springs, CO 80918
Phone (719) 296-4180

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1790749604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671140388",
            "telephone_number": "316-281-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 LATIGO LANE",
            "address_2": "SUITE D",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812128115",
            "telephone_number": "719-371-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1338 Phay Ave",
            "address_purpose": "LOCATION",
            "city": "Canon City",
            "state": "CO",
            "postal_code": "812122399",
            "country_code": "US",
            "telephone_number": "719-285-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "LISA",
        "middle_name": "G",
        "credential": "DNAP, CRNA, NSPMC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "RXA-100001",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "D148418",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CO",
            "license": "APN.0015078-CRNA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

Verify at the official NPI Registry.