Mark R Bussell, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT16267 Issued in CA

Practice address

25455 Barton Rd Ste 208a
Loma Linda, CA 92354-3177

Phone

(909) 558-6799

Fax

(909) 558-6513

NPI assigned

Dec 1, 2006

Sex

Male

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1154499721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25455 BARTON RD STE 208A",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543177",
            "telephone_number": "909-558-6799",
            "fax_number": "909-558-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25455 BARTON RD STE 208A",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543177",
            "telephone_number": "909-558-6799",
            "fax_number": "909-558-6513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSELL",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5207",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT16267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerome Burstein, M.D.
• Robert Craig Burt, MD
• Perry Dean Burtch
• David Bush, M.D.
• Crystal Marie Bushey-Mata, AUD
• Michael Baloaloa Butac
• Rachel Buthorne, PA-C
• Ian Nicholas Butler-Hall, MD
• Alahnah Anaise Butler
• Haley Butler, MD, MPH

• Physical Therapist in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.