Anthony Frederick Bushnell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-1135 Issued in ID

Practice address

315 East Elm
Ste 100
Caldwell, ID 83605

Phone

(208) 459-7415

Fax

(208) 453-3307

NPI assigned

Apr 9, 2014

Last updated

Dec 2, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Saint Alphonsus Regional Medical Center Inc

  • Family Medicine Physician
  • Caldwell, ID
  • NPI 1861676298

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1417376229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-459-7415",
            "fax_number": "208-453-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 EAST ELM",
            "address_2": "STE 100",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "83605",
            "telephone_number": "208-459-7415",
            "fax_number": "208-453-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHNELL",
        "first_name": "ANTHONY",
        "middle_name": "FREDERICK",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cadence Brunzlick, OD
• Eric Ray Burfeind, ATC
• P. Roman Burk, D.P.M.
• Isaac K Burton, DO
• Krista Marie Bush, FNP-C
• Lance Joseph Buxton, N.P.
• Tara Byrne, LMSW
• Caldwell Counseling Associates, PLLC
• Caldwell Internal Medicine Professional Association
• Caldwell of Cascadia, LLC (Caldwell Care of Cascadia)

• Physician Assistant in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.

Verify at the official NPI Registry.