Kim Kroeger-Bushell, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

402471 Issued in NY

Practice address

7 Croton Avenue
Cortlandt Manor, NY 10567

Phone

(914) 962-5800

Fax

(315) 326-4290

NPI assigned

Mar 12, 2012

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1104191097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CROTON AVENUE",
            "city": "CORTLANDT MANOR",
            "state": "NY",
            "postal_code": "10567",
            "telephone_number": "914-962-5800",
            "fax_number": "315-326-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CROTON AVENUE",
            "city": "CORTLANDT MANOR",
            "state": "NY",
            "postal_code": "10567",
            "telephone_number": "914-962-5800",
            "fax_number": "315-326-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROEGER-BUSHELL",
        "first_name": "KIM",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-12",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "474578-1",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Kornreich, MD
• Brenda Kostulas
• John F Koval, RPA
• Shanker Krishnamurthy, M.D.
• Uma Krishnamurthy, MD
• Barry I Krosser, M.D.
• Sharon Kucker
• Kavita Kumar, MD
• Helena Kurian, M.D.
• Eunice Lai, PA-C

• Psychiatric/Mental Health Nurse Practitioner in Cortlandt Manor, NY
• Providers in Cortlandt Manor, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

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