Active NPI
Nathanael James Bush, PT
- Physical Therapist
- Chula Vista, CA
National Provider Identifier
1679048904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT295464
- Practice address
- 1020 Tierra del Rey Ste a-1
Chula Vista, CA 91910-7886 - Phone
- (619) 585-7104
- Fax
- (619) 585-7106
- NPI assigned
- Oct 13, 2018
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT295464 | CA | Primary |
Addresses
Primary practice location
1020 Tierra del Rey Ste a-1
Chula Vista, CA 91910-7886
Mailing address
3760 Convoy St Ste 101
San Diego, CA 92111-3743
Phone (888) 208-8526
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT295464 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539388800000",
"number": "1679048904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3760 CONVOY ST STE 101",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921113743",
"telephone_number": "888-208-8526",
"fax_number": "858-751-0901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 TIERRA DEL REY STE A-1",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919107886",
"telephone_number": "619-585-7104",
"fax_number": "619-585-7106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSH",
"first_name": "NATHANAEL",
"middle_name": "JAMES",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-10-13",
"last_updated": "2018-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT295464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chula Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.