Active NPI
Stephen Philip Bushee, ATC, LATC
- Athletic Trainer
- Chestnut Hill, MA
National Provider Identifier
1639264138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 250
- Practice address
- Boston College, Conte Forum-Room 124
Chestnut Hill, MA 01778 - Phone
- (617) 552-3009
- Fax
- (617) 552-9101
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 250 | MA | Primary |
Addresses
Primary practice location
Boston College, Conte Forum-Room 124
Chestnut Hill, MA 01778
Mailing address
19 Hearthstone Circle
Wayland, MA 01778
Phone (508) 655-3495
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10350 | Other | MA | NATA CERTIFICATION NUMBER |
| 250 | Other | MA | STATE LICENSE NUMBER |
| 215674 | Other | MA | STATE SERIAL NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 250 | MA | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639264138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 HEARTHSTONE CIRCLE",
"city": "WAYLAND",
"state": "MA",
"postal_code": "01778",
"telephone_number": "508-655-3495",
"fax_number": "617-552-9101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BOSTON COLLEGE, CONTE FORUM-ROOM 124",
"city": "CHESTNUT HILL",
"state": "MA",
"postal_code": "01778",
"telephone_number": "617-552-3009",
"fax_number": "617-552-9101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSHEE",
"first_name": "STEPHEN",
"middle_name": "PHILIP",
"credential": "ATC, LATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": "250",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATA CERTIFICATION NUMBER",
"identifier": "10350",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "250",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE SERIAL NUMBER",
"identifier": "215674",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chestnut Hill, MA
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.