Individual provider Active NPI

Nancy Jo Bush, NP

  • Nurse Practitioner
  • Santa Monica, CA
National Provider Identifier
1760607212
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11178 Issued in CA
Practice address
2020 Santa Monica Blvd
Suite 600
Santa Monica, CA 90404-2023
Phone
(310) 633-8400
Fax
(310) 633-8419
NPI assigned
Apr 17, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11178 CA Primary
Clinical Nurse Specialist 364S00000X 573 CA
Oncology Registered Nurse 163WX0200X 280234 CA

Addresses

Primary practice location

2020 Santa Monica Blvd
Suite 600
Santa Monica, CA 90404-2023

Mailing address

5 Bridle LN
Bell Canyon, CA 91307-1117
Phone (310) 633-8400

Other identifiers 3

IdentifierTypeStateIssuer
280234OtherCARN LICENSE
11178OtherCANURSE PRACTIONER
573OtherCACERTIFIED NURSE SPECIALIS

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
573CAMDDental Hygienist
280234CAMDOncology Registered Nurse
11178CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1760607212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BRIDLE LN",
            "city": "BELL CANYON",
            "state": "CA",
            "postal_code": "913071117",
            "telephone_number": "310-633-8400",
            "fax_number": "310-633-8419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 SANTA MONICA BLVD",
            "address_2": "SUITE 600",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042023",
            "telephone_number": "310-633-8400",
            "fax_number": "310-633-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "NANCY",
        "middle_name": "JO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "11178",
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "CA",
            "license": "573",
            "primary": false
        },
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "CA",
            "license": "280234",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "280234",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTIONER",
            "identifier": "11178",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED NURSE SPECIALIS",
            "identifier": "573",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.