Individual provider Active NPI

Marianne Bushman, P.T.

  • Physical Therapist
  • Clearwater, FL
National Provider Identifier
1154450898
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT20825 Issued in FL
Practice address
1011 Jeffords St
Suite B
Clearwater, FL 33756-4070
Phone
(727) 442-8199
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT20825 FL Primary

Addresses

Primary practice location

1011 Jeffords St
Suite B
Clearwater, FL 33756-4070

Mailing address

1011 Jeffords St
Suite B
Clearwater, FL 33756-4070

Other identifiers 1

IdentifierTypeStateIssuer
PT20825OtherFLPHYSICAL THERAPIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090805000434 FL Practitioner - Physical Therapist in Private Practice 4486707635 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT20825FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Musculoskeletal Institute Chartered Current Accepting new patients
Nalin LLC Physical Therapist CurrentSince Aug 6, 2024 Accepting new patients
Musculoskeletal Institute Chartered CurrentSince Mar 9, 2021 Accepting new patients

Locations

5860 Ranch Lake Blvd
Ste 102
Bradenton, FL 34202
Phone (941) 212-1444

1011 Jeffords St
Bldg C
Clearwater, FL 33756
Phone (727) 446-5993

4168 Woodlands Pkwy
Palm Harbor, FL 34685
Phone (727) 785-2545

4600 4th St N
St Petersburg, FL 33703

13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

2044 Trinity Oaks Blvd
Ste 110
Trinity, FL 34655
Phone (813) 978-7000

Networks

  • Optimum HealthCare HMO Network

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1154450898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 JEFFORDS ST",
            "address_2": "SUITE B",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337564070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 JEFFORDS ST",
            "address_2": "SUITE B",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337564070",
            "telephone_number": "727-442-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHMAN",
        "first_name": "MARIANNE",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT20825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST",
            "identifier": "PT20825",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.