Jessie Ann McMullen, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN.CRNA.12815 Issued in OH

Practice address

1 Childrens PLZ
Dayton, OH 45404-1815

Phone

(937) 641-3477

Fax

(937) 641-5410

NPI assigned

Oct 26, 2011

Sex

Female

Sole proprietor

No

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 OH

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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 and National Provider Directory roles.

• Dayton Children'S Specialty Physicians, Inc.

  • Pediatrics Physician
  • Dayton, OH
  • NPI 1225192610

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesiology Services Network LTD

  • Anesthesiology Physician
  • Dayton, OH
  • NPI 1821076779
  Medicare reassignment
• Dayton Children'S Specialty Physicians, Inc.

  • Pediatrics Physician
  • Dayton, OH
  • NPI 1780467555
  NPD

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697328000000",
    "number": "1952687600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933432",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041815",
            "telephone_number": "937-641-3477",
            "fax_number": "937-641-5410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 W Tech Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420955",
            "country_code": "US",
            "telephone_number": "937-641-3880",
            "fax_number": "937-641-6159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "JESSIE",
        "middle_name": "ANN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-26",
        "last_updated": "2023-10-15",
        "certification_date": "2023-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.12815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0068574",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "322859",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cody H McMillan
• Sharon McMillan, BA
• Anna McMinn
• Amy Joann McMullen
• Deborah R McMullen, PCC-SC, LICDC, LSW
• Donald William McMurray, CRNA
• Mitchell Neal McMurray, MD
• Emily McNamara
• Shannon Nichole McNary, LPN
• Sarah Marie McNeely, LCDC II

• Certified Registered Nurse Anesthetist in Dayton, OH
• Providers in Dayton, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2023; 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.