NPIMap

Individual provider Active NPI

Jennifer Lynn Bush, D.C.

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1336310184
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8175 Issued in AZ
Practice address
20860 N Tatum Blvd Ste 290
Phoenix, AZ 85050-4282
Phone
(480) 563-1144
Fax
(480) 563-2371
NPI assigned
Mar 20, 2008
Last updated
Feb 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3949 NC
Chiropractor 111N00000X 6189 CO
Chiropractor 111N00000X 9618 FL
Chiropractor 111N00000X 8175 AZ Primary

Addresses

Primary practice location

20860 N Tatum Blvd Ste 290
Phoenix, AZ 85050-4282

Mailing address

1839 S Alma School Rd Ste 354
Mesa, AZ 85210-3028
Phone (480) 726-2287

Other identifiers 1

IdentifierTypeStateIssuer
000220300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110316001064 AZ Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 0446318083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Physical Medicine and Rehabilitation
Education
Palmer College Chiropractic - Davenport, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Afc Physical Medicine of Desert Ridge,PLLCGroup PAC ID 6507016169, 9 clinicians

Practice addresses (Care Compare)

20860 N Tatum Blvd
Suite 290
Phoenix, AZ 85050-4282
Phone (480) 563-1144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
3949NCMDProfessional Counselor
6189COMDPsychologist
9618FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fit for Life Health Services PA Chiropractor PastSince Sep 5, 2006 Accepting new patients
Afc of Peoria, PLLC Past Accepting new patients
Afc of Tempe PLLC PastSince Feb 1, 2017 Accepting new patients
Afc of Surprise, PLLC Past Accepting new patients
Afc Physical Medicine of San Tan Valley, PLLC Past Accepting new patients
Afc Physical Medicine of Gilbert, PLLC Past Accepting new patients
American Family Chiropractic & Rehab at Desert Ridge, LLC Chiropractor PastSince Mar 1, 2012 Accepting new patients
Afc of Phoenix, PLLC Past Accepting new patients
Fit for Life Health Services LLC Chiropractor Past Accepting new patients
Afc Physical Medicine of Mesa, PLLC Past Accepting new patients
Afc of East Mesa, PLLC Past Accepting new patients

Organizations & group practices 12

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": "1205971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1336310184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 S ALMA SCHOOL RD STE 354",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103028",
            "telephone_number": "480-726-2287",
            "fax_number": "888-316-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20860 N TATUM BLVD STE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504282",
            "telephone_number": "480-563-1144",
            "fax_number": "480-563-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-20",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3949",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "6189",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "9618",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000220300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.