NPIMap

Organization Active NPI

Stephen T. Bushi, M.D.

  • Psychiatry Physician
  • Boise, ID
National Provider Identifier
1306993597
Registry record updated Jan 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
M-5492 Issued in ID
Legal business name
STEPHEN T. BUSHI, M.D.
Practice address
1902 Judith LN
Suite 110
Boise, ID 83705-5235
Phone
(208) 658-0800
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2010

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

Authorized official

Name
Mrs. Lori A Wilkins
Title
Office Manager
Phone
(208) 658-0800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X M-5492 ID Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X NP-379A ID

Addresses

Primary practice location

1902 Judith LN
Suite 110
Boise, ID 83705-5235

Mailing address

1902 Judith LN
Suite 110
Boise, ID 83705-5235
Phone (208) 658-0800

Other identifiers 1

IdentifierTypeStateIssuer
003533000MedicaidID

National Provider Directory

National Provider Directory

Locations

1902 W Judith Ln
#110
Boise, ID 83705
Phone (208) 658-0800

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264464000000",
    "number": "1306993597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 JUDITH LN",
            "address_2": "SUITE 110",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837055235",
            "telephone_number": "208-658-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 JUDITH LN",
            "address_2": "SUITE 110",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837055235",
            "telephone_number": "208-658-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN T. BUSHI, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2010-01-26",
        "status": "A",
        "authorized_official_last_name": "WILKINS",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-658-0800",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "M-5492",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-379A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003533000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; 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.