NPIMap

Organization Active NPI

Willow Anesthesia Services LLC

  • Anesthesiology Physician
  • Oxford, MS
National Provider Identifier
1184575011
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
WILLOW ANESTHESIA SERVICES LLC
Practice address
2704 W Oxford Loop Ste 117
Oxford, MS 38655-5728
Phone
(662) 550-4299
Fax
(662) 580-4324
NPI assigned
Feb 6, 2026
Last updated
Apr 29, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
WILLOW ANESTHESIA SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Authorized official

Name
David Garret McCullenNPI 1902878945
Title
Crna
Phone
(941) 360-1566

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

2704 W Oxford Loop Ste 117
Oxford, MS 38655-5728

Mailing address

2704 W Oxford Loop Ste 117
Oxford, MS 38655-5728
Phone (662) 550-4299

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251222000329 TN Part B Supplier - Clinic/Group Practice 9234279183 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Germantown, TN

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Willow Anesthesia Services LLC2 organizations share this tax ID, including this one
Part of
Willow Anesthesia Services LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2704 West Oxford Loop
Ste 117
Oxford, MS 38655
Phone (662) 550-4299

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1770336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777420800000",
    "number": "1184575011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 W OXFORD LOOP STE 117",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555728",
            "telephone_number": "662-550-4299",
            "fax_number": "662-580-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 W OXFORD LOOP STE 117",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555728",
            "telephone_number": "662-550-4299",
            "fax_number": "662-580-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW ANESTHESIA SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLOW ANESTHESIA SERVICES, LLC",
        "enumeration_date": "2026-02-06",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A",
        "authorized_official_last_name": "MCCULLEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GARRET",
        "authorized_official_title_or_position": "CRNA",
        "authorized_official_telephone_number": "941-360-1566"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.