Active NPI
Robert Kelly Bush, BCTMB
- Massage Therapist
- Oak Park, CA
National Provider Identifier
1366834848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 38642
- Practice address
- 465 Savona Way
Oak Park, CA 91377-4842 - Phone
- (805) 405-1883
- NPI assigned
- Feb 20, 2015
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 38642 | CA | Primary |
Addresses
Primary practice location
465 Savona Way
Oak Park, CA 91377-4842
Mailing address
465 Savona Way
Oak Park, CA 91377-4842
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38642 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424390400000",
"number": "1366834848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "465 SAVONA WAY",
"city": "OAK PARK",
"state": "CA",
"postal_code": "913774842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "465 SAVONA WAY",
"city": "OAK PARK",
"state": "CA",
"postal_code": "913774842",
"telephone_number": "805-405-1883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSH",
"first_name": "ROBERT",
"middle_name": "KELLY",
"credential": "BCTMB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-02-20",
"last_updated": "2015-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "38642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.