Valerie L Bush, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3598 Issued in GA

Practice address

116 Mimosa Dr
Thomasville, GA 31792-6605

Phone

(229) 551-0083

Fax

(229) 227-9642

NPI assigned

Jan 13, 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

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in GA

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

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.

• John D Archbold Memorial Hospital Inc

  • General Acute Care Hospital
  • Thomasville, GA
  • NPI 1194779702
  Medicare reassignment NPD
• Pathology Associates, P.C.

  • Anatomic Pathology Physician
  • Thomasville, GA
  • NPI 1417910043
  NPD
• Archbold Medical Group, Inc.

  • Surgery Physician
  • Thomasville, GA
  • NPI 1831353036
  NPD (past)
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)
• South Georgia Surgical Associates, PC

  • Specialist
  • Thomasville, GA
  • NPI 1235245184
  NPD (past)

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1730168030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MIMOSA DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926605",
            "telephone_number": "229-551-0083",
            "fax_number": "229-227-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MIMOSA DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926605",
            "telephone_number": "229-551-0083",
            "fax_number": "229-227-9642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "VALERIE",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "3598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100000112B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACH STATE",
            "identifier": "100000112A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "368501",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970017094",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100000112A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Burns, AGNP-C
• Rachel Burns, NP
• Kenneth James Burnsed Jr., APRN, FNP-BC
• Amanda Kaye Bush, P.T.A.
• Anna Elise Bush, PHARMD
• Sallie Daniele Bussey, NP
• Courtney Cathleen Butler, PT, DPT
• Lindsay Hogan Butler, M.ED. CCC-SLP
• Jeff W Byrd, M.D.
• Mary A Byrd

• Medical Physician Assistant in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.