Tamika Cherron Bush, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

R0366 Issued in TX

Practice address

21175 Tomball Pkwy # 379
Houston, TX 77070-1655

Phone

(833) 497-9429

NPI assigned

May 9, 2007

Reactivated

Aug 4, 2022

Last updated

Dec 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  Medicare reassignment NPD
• Baylor College of Medicine

  dba BCM Physicians of San Antonio

  • Pediatrics Physician
  • San Antonio, TX
  • NPI 1285079764
  Medicare reassignment NPD
• Bexar Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1548034994
  Medicare reassignment NPD
• Memorial Hermann Hospital Based Physician Group

  • Emergency Medicine Physician
  • Houston, TX
  • NPI 1295363497
  Medicare reassignment NPD
• Victoria Emergency Partners LLC

  • Emergency Medicine Physician
  • Gonzales, TX
  • NPI 1164770996
  Medicare reassignment NPD
• Pure G Kids, LLC

  dba Pure G Kids Wellness

  • Pediatrics Physician
  • Houston, TX
  • NPI 1467945865
  NPD Authorized official

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1962113159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21175 TOMBALL PKWY STE 379",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770701655",
            "telephone_number": "432-701-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21175 TOMBALL PKWY # 379",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770701655",
            "telephone_number": "833-497-9429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N Elm St",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274011004",
            "country_code": "US",
            "telephone_number": "336-716-2255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23900 Katy Fwy",
            "address_purpose": "LOCATION",
            "city": "Katy",
            "state": "TX",
            "postal_code": "774941323",
            "country_code": "US",
            "telephone_number": "281-644-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "replacement_npi": "1962113159",
        "last_name": "BUSH",
        "first_name": "TAMIKA",
        "middle_name": "CHERRON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "deactivation_date": "2022-07-28",
        "reactivation_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "R0366",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2008-01094",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R0366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373523502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909986",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Houston",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "houston",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Houston",
            "address_1": "21175 Tomball Pkwy # 379",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770701655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelly Nicole Bush, MSN, APRN, FNP-C
• Kena Norene Bush, COMMUNITY HEALTH WOR
• Myrna Bush
• Natalie M Bush, MD
• Porsha Bush
• Sita Bushan, MD
• Zeina Bushnaq
• Blair Bellamy Bushong
• Tobin Jay Bushong, PA
• Carole Ann Busick, PH.D.

• Pediatrics Physician in Houston, TX
• Providers in Houston, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.