Individual provider Active NPI

Kena Norene Bush, COMMUNITY HEALTH WOR

  • Community Health Worker
  • Houston, TX
National Provider Identifier
1043079635
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
13146 Issued in TX
Practice address
1908 Granger St Apt 4
Houston, TX 77020-2419
Phone
(183) 223-3808
NPI assigned
Mar 15, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 1175-0313 TX
Community Health Worker 172V00000X 13146 TX Primary

Addresses

Primary practice location

1908 Granger St Apt 4
Houston, TX 77020-2419

Mailing address

1908 Granger St Apt 4
Houston, TX 77020-2419
Phone (183) 223-3808

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

State licenses

LicenseStateTypeSpecialty
13146TXMDCommunity Health Worker
1175-0313TXMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1043079635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 GRANGER ST APT 4",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770202419",
            "telephone_number": "183-223-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 GRANGER ST APT 4",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770202419",
            "telephone_number": "183-223-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "KENA",
        "middle_name": "NORENE",
        "credential": "COMMUNITY HEALTH WOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-15",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "TX",
            "license": "1175-0313",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "TX",
            "license": "13146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.