Ivan Scott Bushman, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN183610 Issued in AZ

Practice address

775 E Willetta St
Phoenix, AZ 85006-2723

Phone

(480) 581-3900

NPI assigned

Jul 22, 2022

Last updated

Jul 22, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1023743960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19044 N LOUSANDRA DR",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851385774",
            "telephone_number": "602-369-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 E WILLETTA ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062723",
            "telephone_number": "480-581-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHMAN",
        "first_name": "IVAN",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-22",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN183610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Bush, D.C.
• Joseph Kerry Bush, M.D.
• Melissa Lynn Bush, RNP
• Sarah Bushbaum, BS, DTR
• Eric Steven Bushman, O.D
• Monique Lynne Bushman, M.D.
• Teresa Renee Bushman
• Mary Lu Bushnell, PSY.D.
• Elby Bushong IV
• Suzanne Bushong

• Registered Nurse in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.