Marc Allen Bush, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601001779 Issued in MI

Practice address

100 Michigan St. NW
Suite A721
Grand Rapids, MI 49503

Phone

(616) 974-4493

NPI assigned

Oct 17, 2006

Last updated

Jan 8, 2013By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Central Michigan Emergency Physicians, P.C.

  • Emergency Medicine Physician
  • Big Rapids, MI
  • NPI 1598856734
  NPD (past)
• Michigan Medical Patient Care

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1073567806
  NPD (past)
• Michigan Medical Patient Care

  • Durable Medical Equipment & Medical Supplies
  • Holland, MI
  • NPI 1871741652
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1043391154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN STREET NW",
            "address_2": "SUITE A721",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-974-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST. NW",
            "address_2": "SUITE A721",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-974-4493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "MARC",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601001779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Busen, LBSW
• Ariana Bush
• Colleen M Bush, MD
• Daniel Arlen Bush
• Jenny Lynn Bush, M.D.
• Mary L. Bush, CRNA
• Tyler Bush, DPT
• William L Bush, MD
• Alex Anthony Bushee
• Jeremy C Bushman, MD

• Medical Physician Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; 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.