Terry W Bushnell, DO
Individual provider Active NPI Cardiovascular Disease Physician · Lebanon, IN
NPI 1104824945 · NPPES record last updated Jun 6, 2022
Key facts
- NPI
- 1104824945
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 02001138A (IN)
- Practice address
- 1310 S Lebanon St # B
Lebanon, IN 46052-2792 - Phone
- (765) 482-0656
- NPI assigned
- Jul 13, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Midwestern University, Chicago College of Osteopathic Med, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Vincent Medical Group Inc
Practice addresses (Care Compare)
1310 S Lebanon St
Suite B
Lebanon, IN 46052-2792
Phone (317) 583-7627
250 W 96TH St
Suite 520
Indianapolis, IN 46260-1317
8433 Harcourt Rd
Suite 100
Indianapolis, IN 46260-2193
Phone (317) 583-7600
Hospital & facility affiliations
- Witham Health Services
- Ascension St Vincent Hospital
- St Vincent Heart Center
- Indiana University Health Frankfort Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100714000824 | IN | Practitioner - Cardiovascular Disease (Cardiology) |
8820145238 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02001138A | IN | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiovascular Consultants of Vincennes, PC | Current |
Accepting new patients | |
| St Vincent Medical Group Inc | Cardiovascular Disease | Past | Accepting new patients |
Locations
2111 Lexington Ave
Lawrenceville, IL 62439
Phone (618) 943-6202
514 S 9th St
Vincennes, IN 47591
Phone (812) 885-6990
Interoperability endpoints
- terry.bushnell.1@7598.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 02001138A | IN | Yes |
Addresses
Primary practice location
1310 S Lebanon St # B
Lebanon, IN 46052-2792
Mailing address
1310 S Lebanon St # B
Lebanon, IN 46052-2792
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100341650 | Medicaid | IN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | terry.bushnell.1@7598.direct.athenahealth.com | St. Vincent Medical Group, Inc. |
Other providers in Lebanon, IN
- Buckeye Senior Rehab LLC
- Chelsea Budd
- Brian W Buoscio
- Della J. Busby
- Melissa Marie Bush
- Campbell Dental Associates Lebanon LLC
- Cyntoya Campbell
- Cancer Care Group, P.C.
- Chloe Carlson
- Kaylei Carlson
All providers in Lebanon, IN · Cardiovascular Disease Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.