Kick the Habit Addiction Medicine, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

KICK THE HABIT ADDICTION MEDICINE, LLC

Practice address

74 S 360 E
American Fork, UT 84003-2590

Phone

(949) 237-2874

Fax

(844) 240-9439

NPI assigned

Nov 28, 2018

Last updated

Mar 5, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Joel Bush, MDNPI 1003070111

Title

Ceo

Phone

(949) 237-2874

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Joel Bush, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Provo, UT
  • NPI 1003070111
  NPD Authorized official

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551744000000",
    "number": "1780154195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 S 360 E",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032590",
            "telephone_number": "949-237-2874",
            "fax_number": "844-240-9439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 S 360 E",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032590",
            "telephone_number": "949-237-2874",
            "fax_number": "844-240-9439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KICK THE HABIT ADDICTION MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-28",
        "last_updated": "2019-03-05",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-237-2874",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Kennedy, COTA
• Kenneth E Hooton, O.D. (Clear View Vision Center)
• J Cameron Kesler, DO
• Keys to Mending Therapy and Wellness, PLLC
• KG Medical Consulting
• Cassidy Kieper
• Claudia Killebrew, CNM
• Tiera Kimball, CSW
• Georgia Ann Kimber, FMT
• Kind Light Counseling PLLC

• Medical Specialty Clinic/Center in American Fork, UT
• Providers in American Fork, UT by specialty
• Medical Specialty Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.