Individual provider Active NPI

Nathan Martin Bush, PHARM.D.

  • Pharmacist
  • Du Bois, PA
National Provider Identifier
1770125015
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP448057 Issued in PA
Practice address
30 W Park Ave
Du Bois, PA 15801-2452
Phone
(814) 371-0800
NPI assigned
Oct 8, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP448057 PA Primary

Addresses

Primary practice location

30 W Park Ave
Du Bois, PA 15801-2452

Mailing address

414 Forsyth Rd
Du Bois, PA 15801-9654
Phone (814) 603-0299

Other practice location 1

240 W Main St Ste D
Brookville, PA 15825-2514
Phone (814) 849-5217

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RP448057PAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1770125015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 FORSYTH RD",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158019654",
            "telephone_number": "814-603-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W PARK AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012452",
            "telephone_number": "814-371-0800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 W Main St Ste D",
            "address_purpose": "LOCATION",
            "city": "Brookville",
            "state": "PA",
            "postal_code": "158252514",
            "country_code": "US",
            "telephone_number": "814-849-5217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSH",
        "first_name": "NATHAN",
        "middle_name": "MARTIN",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP448057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.