Active NPI
Clinton G Bush III, M.D.
- Orthopaedic Surgery Physician
- North Miami, FL
National Provider Identifier
1356347025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- ME25660
- Practice address
- 1966 NE 123Rd St
PMB#120
North Miami, FL 33181-2868 - Phone
- (305) 761-5571
- NPI assigned
- Jun 27, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | ME25660 | FL | Primary |
Addresses
Primary practice location
1966 NE 123Rd St
PMB#120
North Miami, FL 33181-2868
Mailing address
1966 NE 123Rd St
PMB#120
North Miami, FL 33181-2868
Phone (305) 761-5571
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME25660 | FL | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346198400000",
"number": "1356347025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1966 NE 123RD ST",
"address_2": "PMB#120",
"city": "NORTH MIAMI",
"state": "FL",
"postal_code": "331812868",
"telephone_number": "305-761-5571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1966 NE 123RD ST",
"address_2": "PMB#120",
"city": "NORTH MIAMI",
"state": "FL",
"postal_code": "331812868",
"telephone_number": "305-761-5571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSH",
"first_name": "CLINTON",
"middle_name": "G",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-27",
"last_updated": "2012-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "FL",
"license": "ME25660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.