VICKIE CONSUELLA71 BUSH (NPI# 1912464702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912464702 |
| Entity Type | Individual |
| Full Name | VICKIE CONSUELLA71 BUSH |
| Practice Address |
3701 Bermuda Run Dr Valdosta GA 31605-1059 |
| Practice Telephone | 2292920021 |
| Mailing Telephone | 2292920021 |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2019-02-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
456669 | GA | Allopathic & Osteopathic Physicians |
| Y | 253Z00000X | In Home Supportive Care | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | ARRT | 456669 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659372332 | Vickie L Bush | Nurse Practitioner | 4498 N 1st Ave, Evansville, IN 47710-3622 | 2005-08-03 |
| 1548393754 | Vickie Lynn Bush | Counselor | 1125 6th Street Se, Woodland Centers, Willmar, MN 56201-4675 | 2007-03-14 |
| Street Address |
3701 BERMUDA RUN DR |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31605-1059 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484718 | Mckenna Kristine Bachmann | Specialist/Technologist | Moody Air Force Base, Valdosta, GA 31605 | 2020-07-14 |
| 1376056366 | Michael Brent Robinson Sr. | Contractor | 3863 Camellia Dr., Valdosta, GA 31605 | 2017-11-13 |
| 1679013452 | Baptist Specialty Physicians Inc | Pediatrics | 3301 N Oak St Ext, Valdosta, GA 31605 | 2017-02-28 |
| 1649683541 | Dustin Ross Kilby | Dentist | 2704 Oak Center Dr, Valdosta, GA 31605 | 2014-06-09 |
| 1659643286 | Brittnaey Nicole Freeman | Behavioral Analyst | 3982 Karaline Cir, Valdosta, GA 31605 | 2012-01-27 |
| 1780970335 | Laura Christen Cribbs | Counselor | 3312-d N Oak Street Ext, Valdosta, GA 31605 | 2011-06-22 |
| 1992090633 | Mary Katelyn Harper | Pharmacist | 3200 North Oak Street, Valdosta, GA 31605 | 2011-06-10 |
| 1053532937 | Robert Mark Pearson | Dentist | 3227 N. Oak St. Ext., Valdosta, GA 31605 | 2007-05-01 |
| 1083838650 | Am Sleep Diagnostics and Research Center | Clinic/Center | 3334 Greyatone Way, Valdosta, GA 31605 | 2007-04-12 |
| 1831236181 | William Ashley Moorman | Dentist | Advanced Dental Care, 3211 Wildwood Plantation Drive, Valdosta, GA 31605 | 2007-01-30 |
| Find all providers in zip 31605 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457907545 | Georgia Care Group LLC | In Home Supportive Care | 4480 Valnorth Dr Ste D, Valdosta, GA 31602-6818 | 2019-08-14 |
| 1114228665 | Gloria Home Care Agency Inc | In Home Supportive Care | 1808 Plum St, Suite C, Valdosta, GA 31601-7527 | 2010-11-14 |
| 1891811345 | Southern Home Care Services, Inc. | In Home Supportive Care | 1700 E Park Ave, Valdosta, GA 31602-3400 | 2007-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740356 | Charlies Angels Care Corp | In Home Supportive Care | 525 W Broad St, Twin City, GA 30471-4187 | 2020-11-05 |
| 1316547433 | Xl Promise Home Care LLC | In Home Supportive Care | 102 Highland Park Trl, Sandy Springs, GA 30350-3392 | 2020-10-28 |
| 1639779960 | Caring House Home Care Services, LLC | In Home Supportive Care | 1100 Pittsburgh Ave, White Plains, GA 30678 | 2020-10-27 |
| 1518565159 | First Choice Home Health Care LLC | In Home Supportive Care | 600 Westridge Parkway, Suite 707, Mcdonough, GA 30253 | 2020-10-15 |
| 1871100123 | Angella Miller | In Home Supportive Care | 326 Carrington Ln, Douglasville, GA 30135-6712 | 2020-09-29 |
| 1366059222 | Esther Home Care Services LLC | In Home Supportive Care | 3153 Chapel Rd Nw, Kennesaw, GA 30144-4203 | 2020-09-25 |
| 1538776570 | Superior Home Care Services, LLC | In Home Supportive Care | 2242 Young America Dr, Lawrenceville, GA 30043-8011 | 2020-09-24 |
| 1548876816 | Dwe-bah Home Care LLC. | In Home Supportive Care | 1991 Roxey Ln, Winder, GA 30680-6124 | 2020-09-21 |
| 1174138416 | Crossley Seniorcare LLC | In Home Supportive Care | 4321 S Lee St Ste 400, Buford, GA 30518-5776 | 2020-09-14 |
| 1427662634 | V E Health Services LLC | In Home Supportive Care | 3164 Town and Country Road, Donalsonville, GA 39845 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
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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.