Individual provider Active NPI

Nadine K Bush, MD

  • Internal Medicine Physician
  • Mendenhall, MS
National Provider Identifier
1043334568
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MS16456 Issued in MS
Practice address
1842 Simpson Highway 149
Mendenhall, MS 39114-3438
Phone
(601) 847-2221
Fax
(601) 847-7104
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MS16456 MS Primary

Addresses

Primary practice location

1842 Simpson Highway 149
Mendenhall, MS 39114-3438

Mailing address

1842 Simpson Highway 149
Mendenhall, MS 39114-3438
Phone (601) 847-2221

Other identifiers 1

IdentifierTypeStateIssuer
00121967MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20040909001343 MS Practitioner - Emergency Medicine 8325014384 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MS16456MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Sunflower County Hospital Current Accepting new patients
South Sunflower County Hospital Current Accepting new patients
Yazoo Emergency Group, LLC CurrentSince Jun 12, 2022 Accepting new patients
Correct Care, Inc. CurrentSince Jun 1, 2021 Accepting new patients
Internal Medicine Specialists PLLC Internal Medicine CurrentSince Oct 16, 2024 Accepting new patients
Cogent Healthcare of Jackson Ms, LLC Internal Medicine Past Accepting new patients
Marion General Hospital Past Accepting new patients
Holbrook Family Medical Practice, Inc. Past Accepting new patients
Simpson Community Healthcare, Inc. Past Accepting new patients

Locations

229 Saint John Ln
Covington, LA 70433
Phone (866) 875-9225

121 E Baker St
Indianola, MS 38751
Phone (601) 887-3113

1040 River Oaks Dr
Ste 201
Jackson, MS 39232
Phone (601) 429-1150

409 Tyler Holmes Dr
Winona, MS 38967
Phone (662) 283-3060

823 Grand Ave
Yazoo City, MS 39194
Phone (601) 746-2261

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043334568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1842 SIMPSON HIGHWAY 149",
            "city": "MENDENHALL",
            "state": "MS",
            "postal_code": "391143438",
            "telephone_number": "601-847-2221",
            "fax_number": "601-847-7104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1842 SIMPSON HIGHWAY 149",
            "city": "MENDENHALL",
            "state": "MS",
            "postal_code": "391143438",
            "telephone_number": "601-847-2221",
            "fax_number": "601-847-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "NADINE",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "MS16456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00121967",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendenhall, MS

Sources for this page

Verify at the official NPI Registry.