Individual provider Active NPI

Sallyanne Braxton

  • Certified Registered Nurse Anesthetist
  • Panama City, FL
National Provider Identifier
1558042978
Registry record updated Oct 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11033260 Issued in FL
Practice address
4014 W 24TH St
Panama City, FL 32405-1323
Phone
(850) 557-2775
NPI assigned
Jul 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9479222 FL
Certified Registered Nurse Anesthetist 367500000X APRN11033260 FL Primary

Addresses

Primary practice location

4014 W 24TH St
Panama City, FL 32405-1323

Mailing address

4014 W 24TH St
Panama City, FL 32405-1323

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240823001401 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587103437 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Florida State University College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

449 W 23Rd St
Panama City, FL 32405-4507
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9479222FLMDRegistered Nurse
APRN11033260FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Physician Solutions of North Florida, LLC CurrentSince Jun 6, 2024 Accepting new patients
Anesthesia Physician Solutions of North Florida, LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Anesthesia Physician Solutions of North Florida, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 6, 2024 Accepting new patients
Jackson Anesthesia Associates Inc Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2026 Accepting new patients

Locations

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

3024 4th St
Marianna, FL 32446
Phone (850) 258-3148

4250 Hospital Dr
Marianna, FL 32446
Phone (850) 526-2200

2500 Martin Luther King Jr Blvd
Panama City, FL 32405
Phone (850) 522-7951

449 W 23rd St
Panama City, FL 32405
Phone (850) 747-7900

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

325 Cypress Pkwy
Poinciana, FL 34759
Phone (407) 530-2000

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728086400000",
    "number": "1558042978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4014 W 24TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324051323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4014 W 24TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324051323",
            "telephone_number": "850-557-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAXTON",
        "first_name": "SALLYANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2024-10-05",
        "certification_date": "2024-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9479222",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11033260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2024; 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.