Organization Active NPI

Tod R Bushman DPM PC

  • Foot & Ankle Surgery Podiatrist
  • Hermitage, TN
National Provider Identifier
1447450259
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
DPM471 Issued in TN
Legal business name
TOD R BUSHMAN DPM PC
Practice address
5653 Frist Blvd Ste 441
Hermitage, TN 37076-2062
Phone
(615) 885-4424
Fax
(615) 872-2707
NPI assigned
Jul 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Authorized official

Name
Heather M Moon
Title
Office Manager
Phone
(615) 885-4424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X DPM471 TN Primary

Addresses

Primary practice location

5653 Frist Blvd Ste 441
Hermitage, TN 37076-2062

Mailing address

5653 Frist Blvd Ste 441
Hermitage, TN 37076-2062
Phone (615) 885-4424

Other identifiers 1

IdentifierTypeStateIssuer
3376588MedicaidTN

Other names 1

  • Diabetic Foot Center Doing business as

National Provider Directory

National Provider Directory

Locations

5653 Frist Blvd
Ste 441
Hermitage, TN 37076
Phone (615) 885-4424

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260230400000",
    "number": "1447450259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5653 FRIST BLVD STE 441",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762062",
            "telephone_number": "615-885-4424",
            "fax_number": "615-872-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5653 FRIST BLVD STE 441",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762062",
            "telephone_number": "615-885-4424",
            "fax_number": "615-872-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOD R BUSHMAN DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2009-12-08",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "615-885-4424"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TN",
            "license": "DPM471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3376588",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diabetic Foot Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hermitage, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; 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.