Jerry Walter Bush, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

46373 Issued in GA

Practice address

686 S 8TH St
Griffin, GA 30224-4214

Phone

(770) 337-6995

Fax

(770) 233-6229

NPI assigned

Apr 7, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 13, 2019 through Mar 13, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Aylo Health, LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1013018811
  NPD (past)

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952424848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244214",
            "telephone_number": "770-337-6995",
            "fax_number": "770-233-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244214",
            "telephone_number": "770-337-6995",
            "fax_number": "770-233-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "JERRY",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "11435",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "46373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Moreland Burdette
• Lauren W. Burgreen, M.A.
• Valencia Burleson, FNP
• Emily Heape Burns
• Nicole Busbin
• Kalie Mullis Bush, FNP-C
• Surya Prakash Reddy Bussa, MD
• Brandy Bussey
• Jennifer Byrd, LPC
• Tameka Deanne Byrd, D.O.

• Internal Medicine Physician in Griffin, GA
• Providers in Griffin, GA by specialty
• Internal Medicine Physician in Georgia

• 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.