Stephen M. Bush, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MB4635465 Issued in NC

Practice address

5 Firstvillage Drive
Pinehurst, NC 28374

Phone

(910) 295-6831

Fax

(910) 295-0244

NPI assigned

Jan 30, 2014

Last updated

Sep 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stephen M Dixon Other name

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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

• MCPC-9, LLC

  dba FirstHealth Surgical Specialties

  • Orthopaedic Surgery Physician
  • Rockingham, NC
  • NPI 1487919973
  Medicare reassignment
• Pinehurst Surgical Clinic PA

  • Surgery Physician
  • Pinehurst, NC
  • NPI 1962434324
  Medicare reassignment
• Scotland Memorial Hospital, Inc

  dba Harris Family Practice

  • Rural Health Clinic/Center
  • Laurinburg, NC
  • NPI 1417498403
  NPD
• University of Toledo Physicians LLC

  • Internal Medicine Physician
  • Toledo, OH
  • NPI 1942296033

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537142400000",
    "number": "1033532791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 FIRSTVILLAGE DRIVE",
            "address_2": "PO BOX 2000",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "28374",
            "telephone_number": "910-295-6831",
            "fax_number": "910-295-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 FIRSTVILLAGE DRIVE",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "28374",
            "telephone_number": "910-295-6831",
            "fax_number": "910-295-0244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 N Macomb St",
            "address_2": "#300",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "MI",
            "postal_code": "481622900",
            "country_code": "US",
            "telephone_number": "734-240-4240",
            "fax_number": "734-240-4236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSH",
        "first_name": "STEPHEN",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-30",
        "last_updated": "2018-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "MB4635465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0098694",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHEN",
            "last_name": "DIXON",
            "middle_name": "M",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Breanna Burns
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• Julie S. Burris, OTR/L,CLT
• Makayla Burton
• Jessica T Bustos, ANP, RN
• McKenley Landris Byrd, PT, DPT
• C3 Solutions
• Joseph Cain, PAC
• Carolina Calero

• Physician Assistant in Pinehurst, NC
• Providers in Pinehurst, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2018; 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.