Individual provider Active NPI

Candy Lynn Bush, FNP-BC

  • Family Nurse Practitioner
  • Lebanon, VA
National Provider Identifier
1356013403
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024182736 Issued in VA
Practice address
142 Highland Dr
Lebanon, VA 24266-4636
Phone
(276) 889-0433
NPI assigned
Sep 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024182736 VA Primary

Addresses

Primary practice location

142 Highland Dr
Lebanon, VA 24266-4636

Mailing address

1683 Brick Church Cir
Castlewood, VA 24224-5879
Phone (276) 698-8738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20211130000015 VA Practitioner - Nurse Practitioner 6406246859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holston Medical Group PCGroup PAC ID 8224935754, 239 clinicians

Practice addresses (Care Compare)

495 E Main St
Lebanon, VA 24266-4617
Phone (276) 991-6900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024182736VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holston Medical Group PC CurrentSince Nov 5, 2024 Accepting new patients

Locations

121 Advanced Technology Dr
Duffield, VA 24244
Phone (276) 431-2648

495 E Main St
Lebanon, VA 24266
Phone (276) 889-3700

3029 Half Ave
Saint Paul, VA 24283
Phone (276) 738-1900

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1356013403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1683 BRICK CHURCH CIR",
            "city": "CASTLEWOOD",
            "state": "VA",
            "postal_code": "242245879",
            "telephone_number": "276-698-8738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 HIGHLAND DR",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242664636",
            "telephone_number": "276-889-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "CANDY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024182736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, VA

Sources for this page

Verify at the official NPI Registry.