Individual provider Active NPI

Danyelle Denise Bush

  • Home Health Agency
  • Fayetteville, NC
National Provider Identifier
1508904343
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC3121 Issued in NC
Practice address
5012 Paulson Dr
Fayetteville, NC 28304-5145
Phone
(910) 978-8045
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC3121 NC Primary

Addresses

Primary practice location

5012 Paulson Dr
Fayetteville, NC 28304-5145

Mailing address

5012 Paulson Dr
Fayetteville, NC 28304-5145
Phone (910) 978-8045

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

LicenseStateTypeSpecialty
HC3121NCMDHome Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508904343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 PAULSON DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283045145",
            "telephone_number": "910-978-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5012 PAULSON DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283045145",
            "telephone_number": "910-978-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "DANYELLE",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC3121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.