Gwendolyn Hendrix-Bush, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1150 Issued in OK

Practice address

2204 E Main St
Stigler, OK 74462-2822

Phone

(918) 967-9200

NPI assigned

Feb 21, 2006

Sex

Female

Sole proprietor

No

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

77.07 of 100Reported as group

Quality

73.06

Improvement activities

40

Cost

69.92

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Choctaw Nation of Oklahoma

  • Rural Acute Care Hospital
  • Talihina, OK
  • NPI 1659347623

  TX

  Medicare reassignment
• Choctaw Nation of Oklahoma

  • Primary Care Clinic/Center
  • Stigler, OK
  • NPI 1184690026
  NPD
• Choctaw Nation of Oklahoma

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Broken Bow, OK
  • NPI 1447143532
  NPD

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1568437812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 NW 7TH ST",
            "address_2": "P. O. BOX 593",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744621504",
            "telephone_number": "918-967-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 E MAIN ST",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744622822",
            "telephone_number": "918-967-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIX-BUSH",
        "first_name": "GWENDOLYN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heads Pharmacy Inc
• Healthback Home Health of Eastern Oklahoma, Inc.
• Healthflex, Inc.
• Lee Andrea Henderson
• William Henderson
• Tearstine Hickey
• Charles O Higdon III, FNP
• Stephanie Suzanne Hodges, LPC
• Harold Holsan
• Robin L Holsan

• Medical Physician Assistant in Stigler, OK
• Providers in Stigler, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.