Individual provider Active NPI

Jeremy Allen Bush, M.D.

  • Anesthesiology Physician
  • Rogers, AR
National Provider Identifier
1235358565
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
E-6405 Issued in AR
Practice address
3728 S Pinnacle Hills Pkwy
Rogers, AR 72758-8897
Phone
(479) 254-8508
Fax
(479) 282-1479
NPI assigned
Apr 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X E-6405 AR Primary

Addresses

Primary practice location

3728 S Pinnacle Hills Pkwy
Rogers, AR 72758-8897

Mailing address

PO Box 583
Lowell, AR 72745-0583
Phone (888) 991-1101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20100713000372 AR Practitioner - Anesthesiology 5193857035 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renew Medical Group of Arkansas LTDGroup PAC ID 3173056298, 129 clinicians
Youngs Professional Services LLCGroup PAC ID 2163524992, 297 clinicians

Practice addresses (Care Compare)

2708 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 338-8000

2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 338-8000

609 W Maple Ave
Springdale, AR 72764-5335
Phone (479) 757-4001

700 W Grove St
Medical Center of South Arkansas
El Dorado, AR 71730-4416
Phone (870) 863-2000

7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone (479) 314-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-6405ARMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Anesthesia Solutions of Arkansas, LLC Anesthesiology CurrentSince Jan 2, 2023 Accepting new patients
Youngs Professional Services LLC CurrentSince Oct 21, 2023 Accepting new patients
Renew Medical Group of Arkansas LTD Anesthesiology CurrentSince Feb 16, 2025 Accepting new patients
Precision Surgical Center of Northwest Arkansas, LLC PastSince Dec 1, 2022 Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Anesthesiology Past Accepting new patients

Locations

3000 Medical Center Pkwy
Bentonville, AR 72712
Phone (479) 553-2524

3000 Medical Center Pkwy
Fl 2
Bentonville, AR 72712

700 W Grove St
El Dorado, AR 71730
Phone (870) 863-2200

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

603 N Progress Ave
Siloam Springs, AR 72761
Phone (479) 215-3000

609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1235358565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 583",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450583",
            "telephone_number": "888-991-1101",
            "fax_number": "903-787-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3728 S PINNACLE HILLS PKWY",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588897",
            "telephone_number": "479-254-8508",
            "fax_number": "479-282-1479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "JEREMY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E-6405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.