Individual provider Active NPI

Jaymie Lee Bush, LMSW

  • Clinical Social Worker
  • Jackson, MI
National Provider Identifier
1700223633
Registry record updated Jun 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801095147 Issued in MI
Practice address
602 W Michigan Ave
Jackson, MI 49201-1907
Phone
(517) 783-5334
Fax
(517) 783-6064
NPI assigned
Jun 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801095147 MI Primary

Addresses

Primary practice location

602 W Michigan Ave
Jackson, MI 49201-1907

Mailing address

10255 Cement City Hwy
Addison, MI 49220-9550
Phone (765) 661-7752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130821000233 MI Practitioner - Clinical Social Worker 1850534967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
A Healing Place LLCGroup PAC ID 0547575029, 14 clinicians

Practice addresses (Care Compare)

207 1St St
Jackson, MI 49201-2102
Phone (517) 998-4673

209 1St St
Jackson, MI 49201-2102
Phone (517) 998-4673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801095147MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mareck Family and Geriatric Services, P.C. Clinical PastSince Jun 1, 2013 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1370044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370044800000",
    "number": "1700223633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10255 CEMENT CITY HWY",
            "city": "ADDISON",
            "state": "MI",
            "postal_code": "492209550",
            "telephone_number": "765-661-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011907",
            "telephone_number": "517-783-5334",
            "fax_number": "517-783-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "JAYMIE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-01",
        "last_updated": "2013-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.