Individual provider Active NPI

Danielle Bush

  • Chiropractor
  • Apple Valley, MN
National Provider Identifier
1366211468
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7157 Issued in MN
Practice address
14859 Energy Way
Apple Valley, MN 55124-5763
Phone
(952) 432-3333
NPI assigned
Dec 29, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7157 MN Primary

Addresses

Primary practice location

14859 Energy Way
Apple Valley, MN 55124-5763

Mailing address

1562 Ivy Ave E
Saint Paul, MN 55106-2228
Phone (218) 851-0745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240215000352 MN Practitioner - Chiropractic 6608210968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Johnson Spinal Care Associates, P.a.Group PAC ID 4587659719, 4 clinicians

Practice addresses (Care Compare)

3485 Willow Lake Blvd
Suite 100
Vadnais Heights, MN 55110-5153
Phone (952) 432-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7157MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson Spinal Care Associates, P.a. Chiropractor CurrentSince Jan 8, 2024 Accepting new patients

Locations

14859 Energy Way
Saint Paul, MN 55124
Phone (651) 423-5250

3485 Willow Lake Blvd
Ste 100
Vadnais Heights, MN 55110
Phone (651) 484-5567

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.

NPI Registry JSON

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

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1366211468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1562 IVY AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551062228",
            "telephone_number": "218-851-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14859 ENERGY WAY",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551245763",
            "telephone_number": "952-432-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "DANIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-29",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "7157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.