Michayala Bush
Individual provider Active NPI Family Nurse Practitioner · Smithville, GA
NPI 1396288684 · NPPES record last updated Nov 18, 2016
Key facts
- NPI
- 1396288684
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- NCO-000001 (GA)
- Practice address
- 164 Paul St
Smithville, GA 31787-2653 - Phone
- (229) 938-9764
- NPI assigned
- Nov 18, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Middle Flint Area Community Service Board
Practice addresses (Care Compare)
415 N Jackson St
Americus, GA 31709-3015
Phone (229) 931-2504
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA, FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170224000502 | GA | Practitioner - Nurse Practitioner | 1355625062 | Reassigns benefits to 4 organizations |
| I20251110003454 | FL | Practitioner - Nurse Practitioner | 1355625062 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NCO-000001 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Middle Flint Area Community Service Board | Current |
Accepting new patients | |
| Grow Healthcare Group PA | Current |
Accepting new patients | |
| Middle Flint Area Community Service Board | Current |
Accepting new patients | |
| Turning Point Care Center LLC | Current |
Accepting new patients | |
| Turning Point Care Center LLC | Current |
Accepting new patients | |
| Middle Flint Area Community Service Board | Current | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
415 N Jackson St
Americus, GA 31709
Phone (229) 815-5454
715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964
1335 N 5th Street Ext
Cordele, GA 31015
Phone (229) 276-2367
3015 Veterans Pkwy S
Moultrie, GA 31788
Phone (229) 873-6479
940 GA Highway 96
Ste A
Warner Robins, GA 31088
Phone (478) 988-7100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NCO-000001 | GA | Yes |
Addresses
Primary practice location
164 Paul St
Smithville, GA 31787-2653
Mailing address
164 Paul St
PO Box 267
Smithville, GA 31787-2653
Phone (229) 938-9764
Other providers in Smithville, GA
All providers in Smithville, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.