Caron Melba Bush, PT, DPT, SCS, CSCS

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT34819 Issued in CA

Practice address

4501 Broadway FL 1
Oakland, CA 94611-4615

Phone

(510) 752-6295

NPI assigned

Aug 19, 2008

Last updated

Dec 17, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dublin Physical Therapy, Inc

  dba Spine and Sports Physical Therapy

  • Physical Therapist
  • Dublin, CA
  • NPI 1548408735
  NPD (past)
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Ambulatory Surgery Center, Antelope Valley

  • Ambulatory Surgical Clinic/Center
  • Lancaster, CA
  • NPI 1851169965
  NPD (past)
• Sports & Orthopedic Leaders Physical Therapy, Inc

  • Physical Therapist
  • Oakland, CA
  • NPI 1013981760

  Orthopedic

  NPD (past)

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1265689434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 BROADWAY FL 1",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114615",
            "telephone_number": "510-752-6295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 BROADWAY FL 1",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114615",
            "telephone_number": "510-752-6295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "CARON",
        "middle_name": "MELBA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, SCS, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT34819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4501 Broadway Fl 1",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946114615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4501 Broadway Fl 1",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946114615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Caitlin Amanda Busby
• Lindsay Busby, M.D,
• Cassidy Busch, PSY.D.
• Janet D Busch, LCSW
• Kibos Buscovich
• Jacob Bush, BCBA
• Wendy Judith Bush, MS, BCBA
• Fallon Erin Bushee, MD
• Margaret Henderson Busher, LCSW
• Ethan Bushman

• Orthopedic Physical Therapist in Oakland, CA
• Providers in Oakland, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.