NPIMap

Individual provider Active NPI

Cora Mackenzie Bush, PA-C

  • Physician Assistant
  • Hot Springs, SD
National Provider Identifier
1528778396
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61360955 Issued in WA
Practice address
500 N 5TH St
Hot Springs, SD 57747-1480
Phone
(605) 745-2000
NPI assigned
Dec 1, 2022
Last updated
Dec 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61360955 WA Primary

Addresses

Primary practice location

500 N 5TH St
Hot Springs, SD 57747-1480

Mailing address

3903 N Hawthorne St
Spokane, WA 99205-1333
Phone (509) 655-0852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250313003947 SD Practitioner - Physician Assistant 5092237560 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monument Health Network IncGroup PAC ID 5991616427, shared by 12 NPIs, 163 clinicians

Practice addresses (Care Compare)

2140 Junction Ave
Sturgis, SD 57785-2358
Phone (605) 720-2400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA61360955WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Network, Inc. CurrentSince Jan 17, 2025 Accepting new patients
Monument Health Network, Inc. CurrentSince Jan 17, 2025 Accepting new patients
Monument Health Network, Inc. CurrentSince Nov 5, 2025 Accepting new patients
Queen City Regional Medical Clinic Physician Assistant Past Accepting new patients

Locations

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

2140 Junction Ave
Sturgis, SD 57785
Phone (605) 720-2400

Interoperability endpoints

  • Direct secure messaging: cbush.172678@regionalhealth.sdhealthlink.net

Organizations & group practices 6

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.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1528778396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 N HAWTHORNE ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992051333",
            "telephone_number": "509-655-0852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N 5TH ST",
            "city": "HOT SPRINGS",
            "state": "SD",
            "postal_code": "577471480",
            "telephone_number": "605-745-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "CORA",
        "middle_name": "MACKENZIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61360955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, SD

Sources for this page

Verify at the official NPI Registry.