Individual provider Active NPI

Shianne Busch

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1871067983
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4101 Greenbriar Dr Ste 305
Houston, TX 77098-5244
Phone
(346) 888-4400
Fax
(346) 888-4401
NPI assigned
Jan 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.011628 IL
Physician Assistant 363A00000X 0110011400 VA
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4101 Greenbriar Dr Ste 305
Houston, TX 77098-5244

Mailing address

4101 Greenbriar Dr Ste 305
Houston, TX 77098-5244
Phone (346) 888-4400

Other practice location 1

350 Kingwood Medical Dr Ste 220
Kingwood, TX 77339-6406
Phone (346) 888-4400

Other practice location 2

3609 Business Center Dr Ste 124
Pearland, TX 77584-4168
Phone (346) 888-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240523003242 TX Practitioner - Physician Assistant 1557703493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epidermatology PLLCGroup PAC ID 0042555096, 7 clinicians

Practice addresses (Care Compare)

350 Kingwood Medical Dr
Suite 220
Kingwood, TX 77339-6406
Phone (346) 888-4400

3609 Business Ctr Dr
Suite 124
Pearland, TX 77584-4168
Phone (346) 888-4400

4101 Greenbriar Dr
Suite 305
Houston, TX 77098-5244
Phone (346) 888-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.011628ILMDPhysician Assistant
0110011400VAMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1871067983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 GREENBRIAR DR STE 305",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770985244",
            "telephone_number": "346-888-4400",
            "fax_number": "346-888-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 GREENBRIAR DR STE 305",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770985244",
            "telephone_number": "346-888-4400",
            "fax_number": "346-888-4401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Kingwood Medical Dr Ste 220",
            "address_purpose": "LOCATION",
            "city": "Kingwood",
            "state": "TX",
            "postal_code": "773396406",
            "country_code": "US",
            "telephone_number": "346-888-4400",
            "fax_number": "346-888-4401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3609 Business Center Dr Ste 124",
            "address_purpose": "LOCATION",
            "city": "Pearland",
            "state": "TX",
            "postal_code": "775844168",
            "country_code": "US",
            "telephone_number": "346-888-4400",
            "fax_number": "346-888-4401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSCH",
        "first_name": "SHIANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-11",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.011628",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110011400",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.