Individual provider Active NPI

Abigail Debusk, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Bowling Green, KY
National Provider Identifier
1154613768
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
03735 Issued in KY
Practice address
825 2ND Ave
Suite C2
Bowling Green, KY 42101-1786
Phone
(270) 780-2750
NPI assigned
May 15, 2011
Last updated
Jan 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 03735 KY Primary

Addresses

Primary practice location

825 2ND Ave
Suite C2
Bowling Green, KY 42101-1786

Mailing address

239 Chippewa Dr
Bowling Green, KY 42103-1376

Other identifiers 1

IdentifierTypeStateIssuer
376962MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130702000575 KY Practitioner - Sports MedicinePractitioner - Family Practice 7315187929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lincoln Memorial University Medical Department, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

250 Park St
Bowling Green, KY 42101-1760
Phone (270) 781-7178

456 Burnley Rd
Scottsville, KY 42164-6355
Phone (270) 780-2760

466 Burnley Rd
Scottsville, KY 42164-6355
Phone (270) 780-2750

825 2ND Ave E
Bowling Green, KY 42101-1786

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Health Corporation, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Commonwealth Health Corporation, Inc Current Accepting new patients
Commonwealth Health Corporation, Inc. Sports Medicine CurrentSince Jan 1, 2017 Accepting new patients
Commonwealth Health Corporation Past Accepting new patients

Locations

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

825 2nd Ave
Ste C2
Bowling Green, KY 42101
Phone (270) 780-2750

Organizations & group practices 4

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 2

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": "1305417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1154613768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 CHIPPEWA DR",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421031376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 2ND AVE",
            "address_2": "SUITE C2",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011786",
            "telephone_number": "270-780-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBUSK",
        "first_name": "ABIGAIL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-15",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "KY",
            "license": "03735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376962",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.