Active NPI
John C Bush, PSYCHOLOGY
- Clinical Psychologist
- Kent, WA
National Provider Identifier
1932241767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY00000527
- Practice address
- 1819 Central Ave So
South Central BLDG a Ste 111
Kent, WA 98032 - Phone
- (253) 852-5503
- Fax
- (253) 852-3612
- NPI assigned
- Feb 12, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY00000527 | WA | Primary |
Addresses
Primary practice location
1819 Central Ave So
South Central BLDG a Ste 111
Kent, WA 98032
Mailing address
1819 Central Ave So
South Central BLDG a Ste 111
Kent, WA 98032
Phone (253) 852-5503
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190315001002 | WA | Practitioner - Clinical Psychologist | 1355563909 | Practice locations: Gig Harbor, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1970
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
3814 Forest Beach Dr NW
Gig Harbor, WA 98335-5848
Phone (253) 649-4829
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1932241767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1819 CENTRAL AVE SO",
"address_2": "SOUTH CENTRAL BLDG A STE 111",
"city": "KENT",
"state": "WA",
"postal_code": "98032",
"telephone_number": "253-852-5503",
"fax_number": "253-852-3612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1819 CENTRAL AVE SO",
"address_2": "SOUTH CENTRAL BLDG A STE 111",
"city": "KENT",
"state": "WA",
"postal_code": "98032",
"telephone_number": "253-852-5503",
"fax_number": "253-852-3612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSH",
"first_name": "JOHN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "PSYCHOLOGY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY00000527",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.