Forrest K Busch DO

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

DO839 Issued in TN

Legal business name

FORREST K BUSCH DO

Practice address

Dyersburg Skin Clinic
1950 Cook St
Dyersburg, TN 38024

Phone

(731) 286-4300

Fax

(731) 286-8008

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Denise Horner

Title

Off MGR

Phone

(731) 286-4302

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Kimberly Fawver, PA-C

  • Physician Assistant
  • Dyersburg, TN
  • NPI 1598808545
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649349374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 363",
            "address_2": "710 HWY 51 BYPASS",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "38024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DYERSBURG SKIN CLINIC",
            "address_2": "1950 COOK ST",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "38024",
            "telephone_number": "731-286-4300",
            "fax_number": "731-286-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORREST K BUSCH DO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HORNER",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OFF MGR",
        "authorized_official_telephone_number": "731-286-4302"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "TN",
            "license": "DO839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4438037",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Doreen Eleanor Feldhouse, M.D.
• First Choice Medical Care PLLC
• Malissa Carnell Flagg, D.C.
• Timothy Flatman
• Forked Deer River Inpatient Services, PLLC
• Forrest Kenton Busch, D.O. P.C.
• Sandra Jean Fowlkes, APNFNP
• Fresenius Medical Care Dyersburg, LLC
• Julia Frye, NP
• Ashley Michelle Fuller, PHARM.D.

• Non-Pharmacy Dispensing Site in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• Non-Pharmacy Dispensing Site in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.