Individual provider Active NPI

Bennie Joe Mullins Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Newnan, GA
National Provider Identifier
1235111428
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2004036293 Issued in MO
Practice address
1755 Highway 34 E
Suite 1100
Newnan, GA 30265-5631
Phone
(770) 251-2060
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN113064 GA
Certified Registered Nurse Anesthetist 367500000X 2004036293 MO Primary

Addresses

Primary practice location

1755 Highway 34 E
Suite 1100
Newnan, GA 30265-5631

Mailing address

PO Box 73709
Newnan, GA 30271-3709
Phone (770) 251-2060

Other practice location 1

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-1000

Other identifiers 1

IdentifierTypeStateIssuer
917249500MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, GA, AL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20090811000467 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739122052 Reassigns benefits to 1 organization
I20170420001427 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739122052 Reassigns benefits to 12 organizations
I20190809002667 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739122052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Mak Anesthesia Holdings, LLCGroup PAC ID 4284917204, 370 clinicians
Greenland Anesthesia Management, LLCGroup PAC ID 2668886425, 21 clinicians

Practice addresses (Care Compare)

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 702-1806

821 N Cobb St
Milledgeville, GA 31061-2343
Phone (478) 776-4000

Hospital & facility affiliations

  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Navicent Health Baldwin Hospital, Milledgeville, GA, CCN 110150

Merit-based Incentive Payment System (MIPS)

Final score
86.17 of 100Reported as group
Quality
74.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of South Alabama Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2019 Accepting new patients
Sweet Dreams Nurse Anesthesiology LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 28, 2019 Accepting new patients
Interventional Spine and Pain Management Ambulatory Surgical Center CurrentSince Jul 5, 2023 Accepting new patients
USA Health Anesthesia Billing Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2019 Accepting new patients
Mulkey Anesthesiology Associates LLC CurrentSince Jul 5, 2023 Accepting new patients
SG Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2023 Accepting new patients
Sweet Dreams Nurse Anesthesia, Inc. Nurse Anesthetist, Certified Registered CurrentSince Jan 8, 2019 Accepting new patients
WGG Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 7, 2021 Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Oct 5, 2015 Accepting new patients
University of South Alabama Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2019 Accepting new patients
Progressive Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2019 Accepting new patients
Synergy Anesthesiology Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 2, 2019 Accepting new patients
Tift Regional Health System Inc CurrentSince Sep 16, 2019 Accepting new patients
City of Hope Medical Group of Georgia LLC CurrentSince Jun 10, 2017 Accepting new patients
Nmda Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 9, 2019 Accepting new patients
Sentry Anesthesia Management, LLC CurrentSince Apr 3, 2017 Accepting new patients
Tift Regional Health System Inc CurrentSince Sep 16, 2019 Accepting new patients
Greenland Anesthesia Management, LLC CurrentSince Jul 1, 2021 Accepting new patients
Mak Anesthesia Holdings LLC CurrentSince May 24, 2023 Accepting new patients
Freeman Neosho Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Physician Surgery Center LLC Past Accepting new patients
Northland Anesthesiology Inc Past Accepting new patients
Digestive Healthcare of Ga, P.C. PastSince Apr 1, 2019 Accepting new patients
Anesthesia Services of Eastern Jackson County, P.C. Past Accepting new patients
Anesthesia Partners, LTD. Past Accepting new patients
Anesthesia Services of Blue Springs Past Accepting new patients

Locations (25 of 29)

2451 Fillingim St
Mobile, AL 36617
Phone (251) 434-3711

619 Pointe North Blvd
Albany, GA 31721
Phone (229) 883-4707

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

3390 Peachtree Rd NE
Ste 1500
Atlanta, GA 30326
Phone 40492049502501

3870 Medical Park Dr
Ste 100
Austell, GA 30106

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

158 Clinic Ave
Carrollton, GA 30117
Phone (770) 834-1008

160 Clinic Ave
Carrollton, GA 30117
Phone (770) 214-2800

1388 Wellbrook Cir NE
Ste 1500
Conyers, GA 30012

1265 Highway 54 W
Ste 401
Fayetteville, GA 30214
Phone (678) 617-6505

1265 Highway 54 W
Ste 402
Fayetteville, GA 30214
Phone (770) 719-3240

1265 Highway 54 W
Ste 103
Fayetteville, GA 30214
Phone (678) 216-0771

222 Perry Hwy
Hawkinsville, GA 31036
Phone (229) 200-4950

1514 Vernon Rd
Lagrange, GA 30240
Phone (706) 812-2369

763 Old Norcross Rd
Lawrenceville, GA 30046
Phone (678) 985-1994

4339 Roswell Rd
Marietta, GA 30062
Phone (770) 977-8221

4339 Roswell Rd
Marietta, GA 30062

821 N Cobb St
Milledgeville, GA 31061
Phone (478) 454-3500

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

1755 Highway 34 E
Ste 1100
Newnan, GA 30265
Phone (770) 252-7510

4441 Atlanta Rd SE
Ste 312
Smyrna, GA 30080
Phone (470) 956-4200

4441 Atlanta Rd SE
Smyrna, GA 30080
Phone 7707021806 ext. 210

117 Kite Rd
Swainsboro, GA 30401
Phone (248) 972-8725

2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422

2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188

Interoperability endpoints

  • Direct secure messaging: bennie.mullinscrna.p2@direct.aicaorthopedics.nextgenshare.com

Organizations & group practices 26

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.

View all 26

Hospital & facility affiliations 2

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1235111428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73709",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302713709",
            "telephone_number": "770-251-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 HIGHWAY 34 E",
            "address_2": "SUITE 1100",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302655631",
            "telephone_number": "770-251-2060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300467694",
            "country_code": "US",
            "telephone_number": "678-312-1000",
            "fax_number": "678-312-3282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "BENNIE",
        "middle_name": "JOE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN113064",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2004036293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "917249500",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; 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.