Active NPI
Kathryn J. Bush, PH.D.
- Psychologist
- Gulfport, MS
National Provider Identifier
1023169166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 36-605
- Practice address
- 1097 Acadian Dr
Gulfport, MS 39507-3545 - Phone
- (228) 868-6707
- Fax
- (228) 896-0811
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 36-605 | MS | Primary |
Addresses
Primary practice location
1097 Acadian Dr
Gulfport, MS 39507-3545
Mailing address
PO Box 7675
Gulfport, MS 39506-7675
Phone (228) 868-6707
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36-605 | MS | MD | Psychologist |
Interoperability endpoints
- kbush@direct.mhg.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023169166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7675",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395067675",
"telephone_number": "228-868-6707",
"fax_number": "228-896-0811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1097 ACADIAN DR",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395073545",
"telephone_number": "228-868-6707",
"fax_number": "228-896-0811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSH",
"first_name": "KATHRYN",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MS",
"license": "36-605",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.