Individual provider Active NPI

Melissa Lynn Bush, RNP

  • Gerontology Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1245394568
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN079263 Issued in AZ
Practice address
1510 E Flower St
Phoenix, AZ 85014-5656
Phone
(602) 530-6900
Fax
(602) 636-6357
NPI assigned
Dec 21, 2006
Last updated
Jan 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN079263 AZ Primary

Addresses

Primary practice location

1510 E Flower St
Phoenix, AZ 85014-5656

Mailing address

2002 E South Mountain Ave
Phoenix, AZ 85042-8128
Phone (602) 571-1212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091023000540 AZ Practitioner - Nurse Practitioner 5597802512 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of the Valley CurrentSince Jul 24, 2017 Accepting new patients
Hospice of the Valley CurrentSince Jul 24, 2017 Accepting new patients

Locations

1510 E Flower St
Phoenix, AZ 85014
Phone (602) 530-6900

1510 E Flower St
Bldg 1
Phoenix, AZ 85014

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1245394568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 E SOUTH MOUNTAIN AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850428128",
            "telephone_number": "602-571-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 E FLOWER ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850145656",
            "telephone_number": "602-530-6900",
            "fax_number": "602-636-6357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "RNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "RN079263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.