KELLY BUSH (NPI# 1730550724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730550724 |
| Entity Type | Individual |
| Full Name | KELLY BUSH |
| Other Name | KELLY ANN BUSH |
| Practice Address |
528 Main St Phoenix NY 13135-2056 |
| Practice Telephone | 3153418923 |
| Mailing Telephone | 3153418923 |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2015-10-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 284235 | NY | Nursing Service Providers |
| N | 251E00000X | Home Health | 284235 | NY | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 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 |
528 MAIN ST |
| City | PHOENIX |
| State | NY |
| Zip Code | 13135-2056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376772293 | Scott Matthew Palocy | Licensed Practical Nurse | 23 Chestnut Street, Apt B-10, Phoenix, NY 13135 | 2009-07-13 |
| 1831173194 | Paul J Masuicca | Dentist | 218 Cty Rd 57, Phoenix, NY 13135 | 2005-12-01 |
| 1902340359 | Karyn Marie Froio | Registered Nurse | 11 Elm Street, Phoenix, NY 13135 | 2016-12-05 |
| 1003195058 | Courtney Lynn Ricard | Occupational Therapy Assistant | 9151 Frenchmans Creek Dr, Phoenix, NY 13135-1537 | 2011-08-09 |
| 1548427289 | Paul G Lakomski | Pharmacist | 3287 Greenleafe Dr, Phoenix, NY 13135-1538 | 2008-05-20 |
| 1396800454 | David Barber | Internal Medicine | 7 Bridge St, Phoenix, NY 13135-1906 | 2006-12-27 |
| 1598370140 | Amber Barnello | Nurse Practitioner | 7 Bridge St, Phoenix, NY 13135-1906 | 2020-09-10 |
| 1932725868 | Kelsey Cesari | Nurse Practitioner | 7 Bridge St, Phoenix, NY 13135-1906 | 2020-06-16 |
| 1346623691 | Stephanie Forget | Nurse Practitioner | 7 Bridge St, Phoenix, NY 13135-1906 | 2015-07-06 |
| 1477953685 | Northern Oswego County Health Services, Inc. | Clinic/Center | 7 Bridge St, Phoenix, NY 13135-1906 | 2014-08-26 |
| Find all providers in zip 13135 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093313033 | Stephanie Lyn Medina | Licensed Practical Nurse | 2349 N 83rd Dr, Phoenix, AZ 85037-3742 | 2020-10-13 |
| 1134736291 | Rosa Luz Helm | Licensed Practical Nurse | 3434 S 67th Ave, Phoenix, AZ 85043-6523 | 2020-09-23 |
| 1639783160 | Jennifer Nadine Stockton | Licensed Practical Nurse | 2702 W Yorkshire Dr Apt 3100, Phoenix, AZ 85027-3939 | 2020-09-02 |
| 1871149765 | Victoria Elizabeth Bare | Licensed Practical Nurse | 1718 W Vineyard Rd, Phoenix, AZ 85041-5804 | 2019-08-15 |
| 1275096604 | Jenifer Lea Losey | Licensed Practical Nurse | 7728 S 37th Way, Phoenix, AZ 85042-9656 | 2019-04-11 |
| 1407319098 | Jennifer Maynard Pratt | Licensed Practical Nurse | 875 Lamson Rd, Phoenix, NY 13135-9020 | 2019-04-10 |
| 1356814594 | Patricia K Hodge | Licensed Practical Nurse | 33602 N 25th Dr, Phoenix, AZ 85085-6006 | 2019-01-10 |
| 1356843692 | Tirzah Gee-simpson | Licensed Practical Nurse | 4411 E Chandler Blvd Apt 2047, Phoenix, AZ 85048-7671 | 2018-03-02 |
| 1396257762 | Shirley Ann Furlong | Licensed Practical Nurse | Alhambra School District No 68, 4510 N 37th Avenue, Phoenix, AZ 85019 | 2017-10-25 |
| 1467963124 | Quality Outlook | Licensed Practical Nurse | 1717 W Glendale Ave Apt 3011, Phoenix, AZ 85021-8817 | 2017-10-20 |
| Find all providers in PHOENIX | ||||
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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.