Active NPI
Rebecca Dyan Bush, OTR/L
- Occupational Therapist
- Medford, OK
National Provider Identifier
1902265051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2181
- Practice address
- 104 E Cherokee St
Medford, OK 73759-1210 - Phone
- (580) 404-1500
- Fax
- (580) 404-1504
- NPI assigned
- Feb 17, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2181 | OK | Primary |
Addresses
Primary practice location
104 E Cherokee St
Medford, OK 73759-1210
Mailing address
104 E Cherokee St
Medford, OK 73759-1210
Phone (580) 404-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200775830B | Medicaid | OK |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6452 | AZ | MD | Physical Therapist |
| 2181 | OK | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652745600000",
"number": "1902265051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 E CHEROKEE ST",
"city": "MEDFORD",
"state": "OK",
"postal_code": "737591210",
"telephone_number": "580-404-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 E CHEROKEE ST",
"city": "MEDFORD",
"state": "OK",
"postal_code": "737591210",
"telephone_number": "580-404-1500",
"fax_number": "580-404-1504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSH",
"first_name": "REBECCA",
"middle_name": "DYAN",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-17",
"last_updated": "2022-05-17",
"certification_date": "2022-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OK",
"license": "2181",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200775830B",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Medford, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.