Kimberly Bushman, PHD., LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP3946 Issued in MN

Practice address

14551 Judicial Rd Ste 100
Burnsville, MN 55306-4991

Phone

(952) 898-5020

Fax

(952) 898-5858

NPI assigned

Nov 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Bushman Psychological Services LLC

  • Mental Health Counselor
  • Burnsville, MN
  • NPI 1861580607
  Medicare reassignment NPD Authorized official
• Family Support Services Inc.

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD (past)
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1982783221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14551 JUDICIAL RD STE 100",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553064991",
            "telephone_number": "952-898-5020",
            "fax_number": "952-898-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14551 JUDICIAL RD STE 100",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553064991",
            "telephone_number": "952-898-5020",
            "fax_number": "952-898-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHMAN",
        "first_name": "KIMBERLY",
        "credential": "PHD., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "39Q41BU",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "165935-00",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL",
            "identifier": "39Q42BU",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP24334",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "386981400",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58501420",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U CARE",
            "identifier": "167373",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE  BHP",
            "identifier": "20206-02",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA UBH",
            "identifier": "61-77270",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annie L Burton, MD
• Shanmeka Burton
• Chandra Jo Bushard, MA CCC SLP
• Andrea Bushaw, NP
• Bushman Psychological Services LLC
• Tori Bussanmas, MD
• Brenda Lourdes Bustos de Weaver, LGSW
• Sabir Busuri
• Thomas Jacob Butenhoff, MPAS, PA-C
• Abdiladif Buthul

• Psychologist in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; 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.