Active NPI
Charles Robert Bushong Jr., M.D.
- Pediatrics Physician
- Denville, NJ
National Provider Identifier
1023021045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MA03472800
- Practice address
- 16 Pocono Rd
Suite 214
Denville, NJ 07834-2901 - Phone
- (973) 627-6129
- NPI assigned
- Aug 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25MA03472800 | NJ | Primary |
Addresses
Primary practice location
16 Pocono Rd
Suite 214
Denville, NJ 07834-2901
Mailing address
16 Pocono Rd
Suite 214
Denville, NJ 07834-2901
Phone (973) 627-6129
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA03472800 | NJ | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435881600000",
"number": "1023021045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 POCONO RD",
"address_2": "SUITE 214",
"city": "DENVILLE",
"state": "NJ",
"postal_code": "078342901",
"telephone_number": "973-627-6129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 POCONO RD",
"address_2": "SUITE 214",
"city": "DENVILLE",
"state": "NJ",
"postal_code": "078342901",
"telephone_number": "973-627-6129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSHONG",
"first_name": "CHARLES",
"middle_name": "ROBERT",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2015-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA03472800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denville, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.