Active NPI
Thomas Bush, PSYD
- Clinical Psychologist
- Elizabethtown, KY
National Provider Identifier
1285672055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0563
- Practice address
- 1311 N Dixie Hwy
Elizabethtown, KY 42701-2621 - Phone
- (270) 765-2605
- Fax
- (270) 766-1222
- NPI assigned
- Jun 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0563 | KY | Primary |
Addresses
Primary practice location
1311 N Dixie Hwy
Elizabethtown, KY 42701-2621
Mailing address
107 Cranes Roost CT
Elizabethtown, KY 42701-3650
Phone (270) 765-2605
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30605018 | Medicaid | KY | |
| 341172 | Other | KY | TRICARE |
| 11574907 | Other | CAQH | |
| 000000044420 | Other | KY | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Communicare Inc | Past | Accepting new patients | |
| Communicare Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Springfield, KY
- NPI 1083751424
-
- Community/Behavioral Health Agency
- Hodgenville, KY
- NPI 1821419789
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285672055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 CRANES ROOST CT",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427013650",
"telephone_number": "270-765-2605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1311 N DIXIE HWY",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427012621",
"telephone_number": "270-765-2605",
"fax_number": "270-766-1222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSH",
"first_name": "THOMAS",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KY",
"license": "0563",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30605018",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "341172",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11574907",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000044420",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elizabethtown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.