KELLY BUSH (NPI# 1053778787) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053778787 |
| Entity Type | Individual |
| Full Name | KELLY BUSH |
| Credential | APN |
| Practice Address |
4400 Broadway Suite 520 Kansas City MO 64111-3498 |
| Mailing Address |
901 E 104th St Mailstop 400 Kansas City MO 64131 |
| Practice Telephone | 8165314080 |
| Practice Fax Number | 8165310281 |
| Mailing Telephone | 8165999499 |
| Mailing Fax Number | 8169329670 |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2017-11-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
2016000625 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730550724 | Kelly Bush | Licensed Practical Nurse | 528 Main St, Phoenix, NY 13135-2056 | 2015-10-15 |
| 1114308806 | Kelly Bush | Speech-Language Pathologist | 203 E Tall Oaks Cir, Palm Beach Gardens, FL 33410-4451 | 2015-06-18 |
| 1669955357 | Kelly Bush | Licensed Practical Nurse | 2521 N Elms Rd, Flushing, MI 48433-9423 | 2018-09-10 |
| 1437640158 | Kelly Nicole Bush | Registered Nurse | 651 Colliers Way, Weirton, WV 26062-5053 | 2018-05-29 |
| 1689060014 | Kelly Bush | Community Health Worker | 32910 W 13 Mile Rd, Bldg. A, Suite 100, Farmington Hills, MI 48334-1980 | 2015-04-13 |
| 1619380250 | Kelly Otisha Bush | Nurse Practitioner | 3240 S Cobb Dr Se, Smyrna, GA 30080-4194 | 2014-06-10 |
| 1073831079 | Kelly Ann Bush | Pediatrics | 3010 Childrens Way, San Diego, CA 92123-4223 | 2010-05-14 |
| 1235384454 | Kelly Bush | Physical Therapy Assistant | 7233 Whipple Ave Nw, North Canton, OH 44720-7137 | 2008-12-02 |
| 1649321191 | Kelly M Bush | Psychologist | 710 S Broadway Ste 300, Dept of Mental Health, Walnut Creek, CA 94596-5229 | 2007-01-12 |
| Street Address |
4400 BROADWAY SUITE 520 |
| City | KANSAS CITY |
| State | MO |
| Zip Code | 64111-3498 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942205703 | Michael M Vesali | Psychiatry & Neurology | 4400 Broadway, Ste. 520, Kansas City, MO 64111-3498 | 2005-06-17 |
| 1194357129 | Catherine Pogson Lewis | Nurse Practitioner | 4400 Broadway, Suite 206, Kansas City, MO 64111 | 2020-02-07 |
| 1861938102 | Dawn Ferguson | Nurse Practitioner | 4400 Broadway, Suite 540, Kansas City, MO 64111 | 2017-01-10 |
| 1598214306 | Children's Mercy-pediatric Associates | Pediatrics | 4400 Broadway, Suite 206, Kansas City, MO 64111-3498 | 2016-09-22 |
| 1982056537 | Allison White | Pharmacist | 4400 Broadway, Suite 106, Kansas City, MO 64111-3498 | 2016-07-07 |
| 1225499031 | Kayla Kjelshus | Nurse Practitioner | 4400 Broadway, Suite 500, Kansas City, MO 64111-3498 | 2016-03-08 |
| 1194180158 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 4400 Broadway, Suite 302, Kansas City, MO 64111-3498 | 2015-12-17 |
| 1215308762 | Lyndsay Kiely | Nurse Practitioner | 4400 Broadway, Suite#206, Kansas City, MO 64111-3498 | 2015-10-09 |
| 1891165296 | Meagan Reighard | Nurse Practitioner | 4400 Broadway, Ste. 520, Kansas City, MO 64111-3498 | 2015-09-29 |
| 1700262342 | Emily Sue Ryan | Nurse Practitioner | 4400 Broadway, Suite 206, Kansas City, MO 64111-3498 | 2015-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184242810 | Kristen Casey | Psychologist | 4050 Pennsylvania Ave Ste 115, Pmb 2746, Kansas City, MO 64111 | 2020-07-09 |
| 1336765015 | Tyler Hoelting | Chiropractor | 3611 Main Street, Kansas City, MO 64111 | 2020-06-18 |
| 1003452764 | Sarah Anne Heavey | Nurse Practitioner | 4300 Wornall Road, Ste 2000, Kansas City, MO 64111 | 2019-11-18 |
| 1558844241 | Guardian Angels, LLC | Home Health | 4049 Pennsylvania Ave, Kansas City, MO 64111 | 2018-09-10 |
| 1730669169 | Hannah Eagleburger | Physician Assistant | 4321 Wornall Rd, Ste 530, Kansas City, MO 64111 | 2018-08-15 |
| 1316460835 | Kandace Callwell | Counselor | 4106 Baltimore Ave, Kansas City, MO 64111 | 2017-07-18 |
| 1780046250 | Sara Koenemann | Nurse Practitioner | 4400 Broadway St., Ste. 520, Kansas City, MO 64111 | 2016-03-24 |
| 1932586245 | Suzzette Griffith | Acupuncturist | 406 W 34th Street Ste 812, Kansas City, MO 64111 | 2015-05-06 |
| 1972999225 | Timothy O Olatunde | Emergency Medicine | 4410 Wornall Road, Kansas City, MO 64111 | 2015-04-14 |
| 1730595026 | Morgan Nelson | Audiologist | 4230 Wornall Road, Suite 420, Kansas City, MO 64111 | 2014-07-07 |
| Find all providers in zip 64111 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861968612 | Nasir Gebi | Nurse Practitioner | 603 E Minor Dr Apt 202, Kansas City, MO 64131-3688 | 2018-10-19 |
| 1457839573 | Robert Claude Kamtio Kamgoum | Nurse Practitioner | 406 W 34th St Ste 428, Kansas City, MO 64111-3113 | 2018-07-31 |
| 1568434173 | Carol Ann Dickerson | Nurse Practitioner | 8301 State Line Rd, #100, Kansas City, MO 64114-2025 | 2006-02-07 |
| 1598122863 | Elizabeth B Kay | Nurse Practitioner | 1500 Meadow Lake Pkwy, Ste 200, Kansas City, MO 64114-1600 | 2016-01-18 |
| 1568573103 | Joseph Caraway | Nurse Practitioner | 5400 N Oak Trfy, Ste 100, Kansas City, MO 64118-6489 | 2006-08-31 |
| 1063454452 | Jacquelyn E Boan | Nurse Practitioner | 11201 Colorado Ave, Kansas City, MO 64137-2502 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023632932 | Rebecca Theresa Medlock | Nurse Practitioner | 736 Marco Valley Ct, Fenton, MO 63026-5318 | 2020-06-05 |
| 1083233274 | Gina Hart | Nurse Practitioner | 12101 Woodcrest Executive Dr Ste 102, Saint Louis, MO 63141-5047 | 2020-04-08 |
| 1215569512 | Nicole M Wikoff | Nurse Practitioner | 12415 Hickory Grove Ln, Saint Louis, MO 63146-3907 | 2020-02-05 |
| 1124658257 | Amadu Barrie | Nurse Practitioner | 134 Midland Avenue, Maryland Heights, MO 63043 | 2020-01-16 |
| 1922569995 | Sarah Regan | Nurse Practitioner | 1031 Bellevue Ave Ste 100, Saint Louis, MO 63117-1855 | 2019-03-30 |
| 1437615044 | Ashley M Berneking | Nurse Practitioner | 4122 Keaton Crossing Blvd Ste 102, O Fallon, MO 63368-8219 | 2019-02-19 |
| 1174094072 | Michelle Kay Bank | Nurse Practitioner | 12409 Roth Hill Dr, Maryland Heights, MO 63043-2941 | 2018-12-17 |
| 1639613813 | University of Missouri | Nurse Practitioner | 1100 Virginina Ave, Columbia, MO 65212-0001 | 2016-12-07 |
| 1962869990 | Fatma Esen Antakli | Nurse Practitioner | Advanced Pain Centers 190 Industrial Drive, Festus, MO 63028 | 2016-01-21 |
| 1386995595 | Kristina M Nelson | Nurse Practitioner | 5225 Mid America Plz, Saint Louis, MO 63129-0002 | 2012-09-27 |
| Find all providers with the same taxonomy | ||||
| City | KANSAS CITY |
| Zip Code | 64111 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.