Jelanie Rae Bush, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301092782 Issued in MI

Practice address

3537 W Front St
Suite G
Traverse City, MI 49684-7941

Phone

(231) 935-8822

Fax

(231) 935-8837

NPI assigned

Jul 2, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IGDIBA/Endpoint/IGDIBA
• Direct secure messaging: jbush10381@direct.bronsonhg.org
• Direct secure messaging: jelanie.bush@gtcc.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bronson Methodist Hospital

  dba Bronson Medical Group

  • Hospitalist Physician
  • Kalamazoo, MI
  • NPI 1417961137
  Medicare reassignment NPD
• Grand Traverse Children's Clinic

  • Pediatrics Physician
  • Traverse City, MI
  • NPI 1750398871
  NPD (past)
• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1023271780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3537 W FRONT ST",
            "address_2": "SUITE G",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847941",
            "telephone_number": "231-935-8822",
            "fax_number": "231-935-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3537 W FRONT ST",
            "address_2": "SUITE G",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847941",
            "telephone_number": "231-935-8822",
            "fax_number": "231-935-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "JELANIE",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301092782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023271780",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM - BRONSON",
            "identifier": "1417961137",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gracie Rae Burton
• Laura Burtrum
• Brianna Busby
• Jaklyn Bush
• Jamie K Bush, DPT
• Sara Emily Bush
• Rachel Butler
• Robert Kevin Butryn, MD
• Jason Stewart Buttleman, D.C.
• Reigan Buttleman

• Pediatrics Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.