Individual provider Active NPI

Cory Mullis, C-AA

  • Anesthesiologist Assistant
  • Land O' Lakes, FL
National Provider Identifier
1841749744
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA367 Issued in FL
Practice address
2936 Lochcarron Dr
Land O Lakes, FL 34638-7865
Phone
(478) 230-7974
NPI assigned
Oct 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X AA367 FL Primary

Addresses

Primary practice location

2936 Lochcarron Dr
Land O Lakes, FL 34638-7865

Mailing address

2936 Lochcarron Dr
Land O Lakes, FL 34638-7865

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170411002583 FL Practitioner - Anesthesiology Assistant 2365728037 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
AA367FLMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Florida Anesthesiologists, LLC CurrentSince Nov 17, 2022 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Oct 16, 2019 Accepting new patients
Ams National LLC CurrentSince Jun 17, 2024 Accepting new patients
Greater Florida Anesthesiologists, LLC CurrentSince Nov 17, 2022 Accepting new patients
Greater Florida Anesthesiologists, LLC Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Oct 16, 2019 Accepting new patients
Sunshine State Anesthesia Partners LLC CurrentSince Feb 28, 2021 Accepting new patients
S & J PA Past Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

2140 W 68th St
Hialeah, FL 33016
Phone (305) 822-4107

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

14104 Yosemite Dr
Hudson, FL 34667
Phone (727) 869-5040

201 14th St SW
Largo, FL 33770
Phone (727) 588-5222

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

21298 Olean Blvd
Pt Charlotte, FL 33952
Phone (941) 624-7032

460 N State Road 7
Royal Palm Beach, FL 33411
Phone (561) 792-7333

900 Carillon Pkwy
Ste 205
St Petersburg, FL 33716
Phone (727) 561-2710

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

9330 State Road 54
Trinity, FL 34655
Phone (727) 834-4000

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

6733 Gall Blvd
Zephyrhills, FL 33542
Phone (813) 783-8242

7050 Gall Blvd
Zephyrhills, FL 33541
Phone (813) 779-1209

2600 Bruce B Downs Blvd
Zephyrhills, FL 33544
Phone (954) 393-5000

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1841749744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2936 LOCHCARRON DR",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346387865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2936 LOCHCARRON DR",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346387865",
            "telephone_number": "478-230-7974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIS",
        "first_name": "CORY",
        "credential": "C-AA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Land O' Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.