KELLY ANN BUSH (NPI# 1073831079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073831079 |
| Entity Type | Individual |
| Full Name | KELLY ANN BUSH |
| Credential | M.D. |
| Practice Address |
3010 Childrens Way San Diego CA 92123-4223 |
| Mailing Address |
3020 Childrens Way # Mc5003 San Diego CA 92123-4223 |
| Practice Telephone | 8589665811 |
| Mailing Telephone | 8583096300 |
| Enumeration Date | 2010-05-14 |
| Last Update Date | 2020-06-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | A125141 | CA | Allopathic & Osteopathic Physicians |
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
A125141 | CA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 75 Pringle Way Ste 300, Reno, NV 89502 | 7759825000 | 7759825496 |
| Uw Hospital and Clinics, 600 Highland Ave, Madison, WI 537920001 | 6082638556 |
| 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 |
| 1053778787 | Kelly Bush | Nurse Practitioner | 4400 Broadway, Suite 520, Kansas City, MO 64111-3498 | 2016-01-26 |
| 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 |
| 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 |
3010 CHILDRENS WAY |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-4223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013996529 | Kyung E Rhee | Pediatrics | 3010 Childrens Way, San Diego, CA 92123-4223 | 2006-01-12 |
| 1770145260 | Anna Karam | Student in an Organized Health Care Education/Training Program | 3010 Childrens Way, San Diego, CA 92123-4223 | 2019-07-03 |
| 1982091740 | Anusha Preethi Ganesan | Pediatrics | 3010 Childrens Way, 2-west, San Diego, CA 92123-4223 | 2015-04-20 |
| 1427495894 | Megan Rose Paul | Pediatrics | 3010 Childrens Way, San Diego, CA 92123-4223 | 2013-05-25 |
| 1154662583 | Maria Paula Aristizabal | Pediatrics | 3010 Childrens Way, 2-west, San Diego, CA 92123-4223 | 2013-03-11 |
| 1154692473 | Victor Wong | Pediatrics | 3010 Childrens Way, 2-west, San Diego, CA 92123-4223 | 2012-01-18 |
| 1962772970 | Christina Marie Killian-benigno | Nurse Practitioner | 3010 Childrens Way, 2-west, San Diego, CA 92123-4223 | 2012-01-06 |
| 1326315599 | Jennifer Caroline Yu | Pediatrics | 3010 Childrens Way, 2-west, San Diego, CA 92123-4223 | 2011-11-16 |
| 1770871105 | Yoko Tina Udaka | Pediatrics | 3010 Childrens Way, San Diego, CA 92123-4223 | 2011-07-19 |
| 1861788093 | San Diego Diagnostic Radiology Medical Group, Inc. | Clinic/Center | 3010 Childrens Way, Suite Ll220, San Diego, CA 92123-4223 | 2011-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
| Find all providers in zip 92123 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447527833 | Nicholas Joseph Gloude | Pediatrics | 3010 Childrens Way Fl 2, San Diego, CA 92123-4223 | 2011-11-29 |
| 1104261502 | Katherine Clark Pehlivan | Pediatrics | 3010 Childrens Way # 2-west, San Diego, CA 92123-4223 | 2013-04-30 |
| 1154662583 | Maria Paula Aristizabal | Pediatrics | 3010 Childrens Way, 2-west, San Diego, CA 92123-4223 | 2013-03-11 |
| 1326315599 | Jennifer Caroline Yu | Pediatrics | 3010 Childrens Way, 2-west, San Diego, CA 92123-4223 | 2011-11-16 |
| 1568510543 | Pamela J. Lammers | Pediatrics | 4647 Zion Ave, San Diego, CA 92120-2507 | 2007-01-08 |
| 1962550939 | Wellington Loh Jr. | Pediatrics | 4647 Zion Ave, San Diego, CA 92120-2507 | 2007-01-08 |
| 1306900022 | Ralph Charles Pene | Pediatrics | 34800 Bob Wilson Drive, San Diego, CA 92134 | 2006-12-20 |
| 1255403879 | Hyunah Ahn | Pediatrics | 3010 Childrens Way, 2-west, San Diego, CA 92123-4223 | 2006-11-15 |
| 1245302561 | William Delbert Roberts | Pediatrics | 3010 Childrens Way, 2-west, San Diego, CA 92123-4223 | 2006-11-14 |
| 1922179779 | Deborah Ellen Schiff | Pediatrics | 3010 Childrens Way, 2-west, San Diego, CA 92123-4223 | 2006-11-13 |
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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.