Individual provider Active NPI

Ryan Bush

  • Psychiatric/Mental Health Nurse Practitioner
  • Mount Vernon, OH
National Provider Identifier
1780363341
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0034229 Issued in OH
Practice address
112 Harcourt Rd Ste 2
Mount Vernon, OH 43050-3944
Phone
(614) 987-8847
NPI assigned
Jul 12, 2023
Last updated
Jul 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0034229 OH Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN.501365 OH

Addresses

Primary practice location

112 Harcourt Rd Ste 2
Mount Vernon, OH 43050-3944

Mailing address

508 Jackson St
Columbus, OH 43206-1353
Phone (614) 535-5125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20230912003460 OH Practitioner - Nurse Practitioner 3678937455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Quest Recovery Center, LLCGroup PAC ID 3476974718, 15 clinicians

Practice addresses (Care Compare)

3094 W Market St
Suite 360
Fairlawn, OH 44333-3618
Phone (614) 987-8847

401 W High St
Suite 9
Mount Vernon, OH 43050-2346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN.501365OHMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Quest Recovery Center, LLC Current Accepting new patients
Quest Recovery Center, LLC CurrentSince Aug 8, 2023 Accepting new patients

Locations

3094 W Market St
Ste 360
Fairlawn, OH 44333
Phone (614) 987-8847

112 Harcourt Rd
Ste 2
Mount Vernon, OH 43050
Phone (614) 314-4568

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1780363341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 JACKSON ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432061353",
            "telephone_number": "614-535-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HARCOURT RD STE 2",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430503944",
            "telephone_number": "614-987-8847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0034229",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OH",
            "license": "RN.501365",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, OH

Sources for this page

Verify at the official NPI Registry.