Marty McCullough, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

ARNP3323342 Issued in FL

Practice address

611 Zeagler Dr
Palatka, FL 32177-3810

Phone

(386) 326-7865

NPI assigned

Jun 2, 2009

Last updated

Feb 14, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physicians Group Services PAGroup PAC ID 1254238579, 91 clinicians

Gulf-to-Bay Anesthesiology Associates LLCGroup PAC ID 5092628156, 330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Putnam Hospital Hospital, Palatka, FL, CCN 100232

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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.

• Gulf-to-Bay Anesthesiology Associates LLC

  • Anesthesiology Physician
  • Tampa, FL
  • NPI 1720039746
  Medicare reassignment Care Compare group NPD
• Physicians Group Services PA

  dba Coastal Health

  • Family Medicine Physician
  • Orange Park, FL
  • NPI 1861440810
  Medicare reassignment Care Compare group NPD
• Northstar Anesthesia of Florida LLC

  • Anesthesiology Physician
  • Irving, TX
  • NPI 1568056166

  FL

  Medicare reassignment NPD
• Gulf-to-Bay Anesthesiology Associates LLC

  • Anesthesiology Physician
  • Largo, FL
  • NPI 1316205339
  NPD
• Physicians Group Services PA

  dba Coastal Health

  • Durable Medical Equipment & Medical Supplies
  • Middleburg, FL
  • NPI 1699170035
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Putnam Community Medical Center of North Florida, LLC

  dba HCA Florida Putnam Hospital

  • General Acute Care Hospital
  • Palatka, FL
  • NPI 1487045100
  Care Compare affiliation

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1366678575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3123",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320853123",
            "telephone_number": "904-824-4990",
            "fax_number": "904-824-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 ZEAGLER DR",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773810",
            "telephone_number": "386-326-7865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "MARTY",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-02",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP3323342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002134100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "G00CF",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Quanteria McCaskill
• Shani D McCaskill, LCSW
• Hashunda McClendon
• Ashley Nicole McCormick
• Katrice Lavella McCormick
• Ashani McDonald, PHARMD
• Elizabeth Ann McKinley, COTA
• Venus Mone' McRae, RN
• Evan McVicker
• Med Ex

• Certified Registered Nurse Anesthetist in Palatka, FL
• Providers in Palatka, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; 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.