Individual provider Active NPI

Sally J Cullen, CRNA

  • Certified Registered Nurse Anesthetist
  • Daytona Beach, FL
National Provider Identifier
1679595078
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP742382 Issued in FL
Practice address
303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Phone
(386) 425-4000
NPI assigned
Jul 24, 2006
Last updated
Aug 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP742382 FL Primary

Addresses

Primary practice location

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709

Mailing address

PO Box 935921
Atlanta, GA 31193-5921

Other practice location 1

550 Memorial Cir Ste H
Ormond Beach, FL 32174-5055
Phone (386) 231-5257

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040910000062 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305812397 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Practice addresses (Care Compare)

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone (386) 231-6000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Dec 10, 2020 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Dec 10, 2020 Accepting new patients
Florida Hospital Healthcare Partners, Inc CurrentSince Jun 7, 2024 Accepting new patients
Advanced Gastroenterology Health Care Centers CurrentSince Sep 1, 2000 Accepting new patients
Volusia Anesthesia Associates Past Accepting new patients
Halifax Anesthesiology Associates PA PastSince May 15, 2013 Accepting new patients

Locations

1890 Lpga Blvd
Ste 200
Daytona Beach, FL 32117
Phone (386) 274-3232

1890 Lpga Blvd
Ste 210
Daytona Beach, FL 32117
Phone (386) 274-0097

301 Memorial Medical Pkwy
Daytona Beach, FL 32117
Phone (386) 231-3906

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

311 N Clyde Morris Blvd
Ste 350
Daytona Beach, FL 32114
Phone (386) 255-1266

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

550 Memorial Cir
Ste H
Ormond Beach, FL 32174
Phone (386) 672-0017

315 Palm Coast Pkwy NE
Ste 5
Palm Coast, FL 32137
Phone (386) 763-4920

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

1690 Dunlawton Ave
Ste 210
Port Orange, FL 32127
Phone (386) 763-4920

1690 Dunlawton Ave
Ste 230
Port Orange, FL 32127
Phone (386) 763-4920

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 6

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1679595078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 935921",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311935921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-425-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Memorial Cir Ste H",
            "address_purpose": "LOCATION",
            "city": "Ormond Beach",
            "state": "FL",
            "postal_code": "321745055",
            "country_code": "US",
            "telephone_number": "386-231-5257",
            "fax_number": "386-231-3695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "SALLY",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP742382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.