Jack Leonard Bushey, R.P.T.,M.S
Individual provider Active NPI Physical Therapist · Yuba City, CA
NPI 1952385205 · NPPES record last updated Aug 24, 2007
Key facts
- NPI
- 1952385205
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT8935 (CA)
- Practice address
- 620 Bridge St
Yuba City, CA 95991-3821 - Phone
- (530) 674-3656
- Fax
- (530) 674-3763
- NPI assigned
- Nov 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120215000694 | CA | Practitioner - Physical Therapist in Private Practice | 8325206618 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT8935 | CA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT8935 | CA | Yes |
Addresses
Primary practice location
620 Bridge St
Yuba City, CA 95991-3821
Mailing address
620 Bridge St
Yuba City, CA 95991-3821
Phone (530) 674-3656
Other providers in Yuba City, CA
- Thomas Ward Burk
- Robert Earl Burky Jr.
- Kayla Burleson-Nelson
- Heather Regina Burrel
- Michael Bush
- Angela Kristine Butler
- Shakira M Butler
- Butte County
- Butte Horizon Detox, LLC.
- Butte Horizon Detox, LLC.
All providers in Yuba City, CA · Physical Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.