Sally Sullivan, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Jackson, MS

Sally Sullivan, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Jackson, Mississippi. She graduated from nursing school in 2016 and has 8 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Gac Anesthesia Llc and her current practice location is 971 Lakeland Dr, Jackson, Mississippi. You can reach out to her office (for appointments etc.) via phone at (334) 279-1450.

Sally Sullivan is licensed to practice in Mississippi (license number R892793) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1609223205.

Contact Information

Sally Sullivan, CRNA
971 Lakeland Dr,
Jackson, MS 39216-4643
(334) 279-1450
(334) 395-4110

Map and Direction




Provider's Profile

Full NameSally Sullivan
GenderFemale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience8 Years
Location971 Lakeland Dr, Jackson, Mississippi
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Sally Sullivan graduated from nursing school in 2016
  NPI Data:
  • NPI Number: 1609223205
  • Provider Enumeration Date: 05/24/2016
  • Last Update Date: 05/24/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 2860787975
  • Enrollment ID: I20160827000203

Medical Identifiers

Medical identifiers for Sally Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1609223205NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered R892793 (Mississippi)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Gac Anesthesia Llc45879026638

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Sally Sullivan allows following entities to bill medicare on her behalf.
Entity NamePhysicians Anesthesia Group, P.a.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407890783
PECOS PAC ID: 6103806864
Enrollment ID: O20040722001098
Entity NameLifelinc Anesthesia Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1801021464
PECOS PAC ID: 0941347447
Enrollment ID: O20130522000277
Entity NameGac Anesthesia Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1386112639
PECOS PAC ID: 4587902663
Enrollment ID: O20190214002975

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sally Sullivan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Sally Sullivan, CRNA
Po Box 4608,
Jackson, MS 39296-4608

Ph: (334) 279-1450
Sally Sullivan, CRNA
971 Lakeland Dr,
Jackson, MS 39216-4643

Ph: (334) 279-1450

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Jackson, MS

Emily Sumrall Childress, CRNA
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Zachary Halliwell, CRNA
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Medicare: Accepting Medicare Assignments
Practice Location: 969 Lakeland Dr, Jackson, MS 39216
Phone: 601-200-2000    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.