NPIMap

Individual provider Active NPI

Kaitlin Bush, PA-C

  • Physician Assistant
  • Owingsville, KY
National Provider Identifier
1104570142
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1192698 Issued in KY
Practice address
632 Slate Ave
Owingsville, KY 40360-2206
Phone
(606) 674-6386
Fax
(606) 674-3096
NPI assigned
Feb 8, 2022
Last updated
Nov 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1192698 KY Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

632 Slate Ave
Owingsville, KY 40360-2206

Mailing address

PO Box 1120
Owingsville, KY 40360-1120
Phone (606) 674-6386

Other practice location 1

205 Keelridge Dr
Georgetown, KY 40324-2517
Phone (606) 339-5247

Other identifiers 1

IdentifierTypeStateIssuer
1192698OtherKYCERTIFICATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230125000881 KY Practitioner - Physician Assistant 5698146918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Claire Medical Center IncGroup PAC ID 4486559085, 181 clinicians

Practice addresses (Care Compare)

632 Slate Ave
Owingsville, KY 40360-2206
Phone (606) 674-6386

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.64 of 100Reported as group
Quality
56.63
Improvement activities
40
Cost
74.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1192698KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Claire Medical Center, Inc Single Specialty CurrentSince Nov 27, 2022 Accepting new patients
St. Claire Medical Center, Inc Single Specialty Current Accepting new patients
St. Claire Medical Center, Inc Single Specialty Current Accepting new patients
St. Claire Medical Center,Inc Single Specialty Current Accepting new patients
St Claire Medical Center, Inc CurrentSince Dec 12, 2022 Accepting new patients
St. Claire Medical Center,Inc Single Specialty Current Accepting new patients
St Claire Regional Radiology Physicians Services Single Specialty Current Accepting new patients
St Claire Medical Center, Inc., Single Specialty CurrentSince Dec 12, 2022 Accepting new patients
St Claire Medical Center, Inc., Single Specialty Current Accepting new patients
St Claire Regional Medical Center PastSince Nov 27, 2022 Accepting new patients

Locations

732 Highway 36
Frenchburg, KY 40322
Phone (606) 768-2191

222 Medical Cir
Morehead, KY 40351
Phone (606) 783-6455

245 Flemingsburg Rd
Morehead, KY 40351
Phone (606) 780-5500

316 W 2nd St
Morehead, KY 40351
Phone (606) 783-6400

632 Slate Ave
Owingsville, KY 40360
Phone (606) 674-6386

390 S Ky 7
Sandy Hook, KY 41171
Phone (606) 738-5155

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1104570142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1120",
            "city": "OWINGSVILLE",
            "state": "KY",
            "postal_code": "403601120",
            "telephone_number": "606-674-6386",
            "fax_number": "606-674-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 SLATE AVE",
            "city": "OWINGSVILLE",
            "state": "KY",
            "postal_code": "403602206",
            "telephone_number": "606-674-6386",
            "fax_number": "606-674-3096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Keelridge Dr",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "KY",
            "postal_code": "403242517",
            "country_code": "US",
            "telephone_number": "606-339-5247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSH",
        "first_name": "KAITLIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "1192698",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATION",
            "identifier": "1192698",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owingsville, KY

Sources for this page

Verify at the official NPI Registry.