Individual provider Active NPI

Sheldon E Millican, CRNA

  • Certified Registered Nurse Anesthetist
  • Rome, GA
National Provider Identifier
1518067487
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN105739 Issued in TN
Practice address
11 John Maddox Dr NW
Rome, GA 30165-1413
Phone
(706) 295-3992
NPI assigned
Sep 22, 2006
Last updated
Nov 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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 APN12203 TN
Certified Registered Nurse Anesthetist 367500000X RN105739 TN Primary
Certified Registered Nurse Anesthetist 367500000X RN128491 GA

Addresses

Primary practice location

11 John Maddox Dr NW
Rome, GA 30165-1413

Mailing address

9639 Waycross Cir
Ooltewah, TN 37363-9451
Phone (423) 315-9542

Other identifiers 1

IdentifierTypeStateIssuer
4137599OtherTNBCBSTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95
Promoting interoperability
96
Improvement activities
40
Cost
81.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
12203TNMDGeneral Practice Dentistry
APN12203TNMDCertified Registered Nurse Anesthetist
RN105739TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
SG Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2023 Accepting new patients
RG Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2014 Accepting new patients
JC Anesthesia LLC CurrentSince May 26, 2023 Accepting new patients
Au Anesthesiology LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 16, 2021 Accepting new patients
Anesthesiologists Associated PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesiologists Associated PC Past Accepting new patients
Gastroenterology Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered PastSince Jul 4, 2021 Accepting new patients
Ahp of Central Georgia, PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3303 Glynn Ave
Brunswick, GA 31520
Phone (912) 354-4800

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

11 John Maddox Dr NW
Rome, GA 30165
Phone (406) 295-3992

5669 Ptree Dunwoody Rd NE
Ste 210
Sandy Springs, GA 30342
Phone (404) 255-4333

728 E 67th St
Savannah, GA 31405
Phone (912) 352-3120

1090 Experiment Station Rd
Unit 529
Watkinsville, GA 30677
Phone (706) 621-4108

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1518067487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9639 WAYCROSS CIR",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373639451",
            "telephone_number": "423-315-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 JOHN MADDOX DR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651413",
            "telephone_number": "706-295-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLICAN",
        "first_name": "SHELDON",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN12203",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN105739",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN128491",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTN",
            "identifier": "4137599",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.