Kimberly Monique Bush, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

25947 Issued in SC

Practice address

448 Lakeshore Pkwy Ste 110
Rock Hill, SC 29730-4264

Phone

(803) 329-3177

NPI assigned

Oct 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, AR2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• South Carolina Dept of Mental Health Accounting Office

  • Primary Care Nurse Practitioner
  • Bennettsville, SC
  • NPI 1295332690
  Medicare reassignment NPD
• Arisa Health, Inc.

  • Community/Behavioral Health Agency
  • Springdale, AR
  • NPI 1437750411
  Medicare reassignment NPD
• Counseling Associates Inc

  • Community/Behavioral Health Agency
  • Russellville, AR
  • NPI 1649381120
  Medicare reassignment NPD
• Ozark Guidance Center, Inc

  • Community/Behavioral Health Agency
  • Springdale, AR
  • NPI 1609875186
  Medicare reassignment NPD
• Professional Counseling Associates Inc.

  • Community/Behavioral Health Agency
  • North Little Rock, AR
  • NPI 1437164977
  Medicare reassignment NPD
• South Carolina Dept of Mental Health Accounting Office

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1083421994
  NPD
• South Carolina Dept of Mental Health Accounting Office

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rock Hill, SC
  • NPI 1568476885
  NPD
• Arisa Health, Inc.

  • Community/Behavioral Health Agency
  • Jonesboro, AR
  • NPI 1306532767
  NPD
• Counseling Associates, Inc

  • Family Medicine Physician
  • Russellville, AR
  • NPI 1962169607
  NPD
• Counseling Associates, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Heber Springs, AR
  • NPI 1144701848
  NPD
• Ozark Guidance Center, Inc

  • Family Medicine Physician
  • Springdale, AR
  • NPI 1659945194
  NPD
• Professional Counseling Associates Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lonoke, AR
  • NPI 1356965990
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1083704837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036818",
            "telephone_number": "704-443-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 LAKESHORE PKWY STE 110",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297304264",
            "telephone_number": "803-329-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "KIMBERLY",
        "middle_name": "MONIQUE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "2008-00209",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "SC",
            "license": "25947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Burroughs
• Paul J Burt, O.D.
• Nancy M. Burton, M.S., P.T.
• Nija Rhonda Burwell
• Darcy J. Burzynski, CRNA
• Craig C Butler, LISW
• John L Butler Jr., PTA
• William Butler
• Butlers Behavioral Health Services
• Butterflies Home Care

• Child & Adolescent Psychiatry Physician in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Child & Adolescent Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.