MR. KENNETH MICHAEL BUSH (NPI# 1992002935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992002935 |
| Entity Type | Individual |
| Full Name | MR. KENNETH MICHAEL BUSH |
| Credential | RPH |
| Practice Address |
21000 E 12 Mile Rd Ste 124 Saint Clair Shores MI 48081-1116 |
| Practice Telephone | 5864475030 |
| Practice Fax Number | 5864475034 |
| Mailing Telephone | 5864475030 |
| Mailing Fax Number | 5864475034 |
| Enumeration Date | 2011-02-25 |
| Last Update Date | 2011-02-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 5302030514 | MI | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497084578 | Kenneth Aaron Bush | Physical Therapist | 725 Wilcox St, Castle Rock, CO 80104-1740 | 2009-12-18 |
| 1093354649 | Kenneth Bradley Bush II | Pharmacist | 3095 Goodman Rd E, Southaven, MS 38672-8707 | 2019-12-31 |
| 1528020682 | Kenneth W. Bush | Physician Assistant | 2311 Lewisville Clemmons Rd, Clemmons, NC 27012-8905 | 2006-04-04 |
| Street Address |
21000 E 12 MILE RD STE 124 |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48081-1116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255330486 | Jennifer Kay Appleyard | Allergy & Immunology | 21000 E 12 Mile Rd, Ste 111, Saint Clair Shores, MI 48081-1116 | 2005-07-19 |
| 1881203479 | Andrew Michael Keltz | Speech-Language Pathologist | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2020-07-29 |
| 1770120230 | Holly Ann Reckers | Speech-Language Pathologist | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2019-12-04 |
| 1578037966 | Maria Juliana Codino | Speech-Language Pathologist | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2019-01-18 |
| 1942779921 | Maria D Samsa | Physician Assistant | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2018-11-19 |
| 1801331210 | Katja N Tandarich | Nurse Practitioner | 21000 E 12 Mile Rd, Suite 111, Saint Clair Shores, MI 48081-1116 | 2016-12-21 |
| 1053854133 | Jean P. Skeffington | Speech-Language Pathologist | 21000 E 12 Mile Rd, Suite111, Saint Clair Shores, MI 48081-1116 | 2016-11-22 |
| 1134588254 | Alyssa Domenica Baker | Physician Assistant | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2016-02-17 |
| 1316350192 | Seton Health Corporation of Southeastern Michigan | Clinic/Center | 21000 E 12 Mile Rd, Suite 105, Saint Clair Shores, MI 48081-1116 | 2014-06-09 |
| 1720404775 | Sean Anthony Cassleman | Internal Medicine | 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 | 2014-03-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750865416 | Saint Clair Family Pharmacy LLC | Pharmacy | 28001 Harper Ave., Saint Clair Shores, MI 48081 | 2018-09-19 |
| 1669995783 | Terra Laquay Ginther | Social Worker | 28800 Harper Ave Ste A, Saint Clair Shores, MI 48081 | 2017-07-20 |
| 1245676998 | Julia Hanson | Social Worker | 27941 Harper Ave., Suite 105, St. Clair Shores, MI 48081 | 2013-05-21 |
| 1760731301 | Life Transition Service | Community/Behavioral Health | 21031 Sunnydale, St. Clair Shore, MI 48081 | 2012-08-29 |
| 1477868792 | William Burr Wood | Pharmacist | 21000 Twelve Milerd., St Clair Shores, MI 48081 | 2010-08-11 |
| 1508094350 | Dominic Anthony Garrisi | Anesthesiology | 21018 Bon Brae, St. Clair Shores, MI 48081 | 2009-06-30 |
| 1992947022 | Karen Ostrowski-thomas | Occupational Therapist | 22442 Bayview, St. Clair Shores, MI 48081 | 2009-04-06 |
| 1891979787 | Chirag Rachhadia | Physical Therapist | 29150 Harper Avenue, St. Clair Shores, MI 48081 | 2007-12-27 |
| 1598955114 | Donna Warner Manczak | Psychologist | 21400 E Eleven Mil Rd, St Clair Shores, MI 48081 | 2007-07-30 |
| 1467652347 | Sumit Narayanprasad Fogla | Family Medicine | 21400 E Eleven Mile Road, St. Clair Shores, MI 48081 | 2007-07-19 |
| Find all providers in zip 48081 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770028490 | Michael Wodecki | Pharmacist | 22431 Lavon St, Saint Clair Shores, MI 48081-2016 | 2017-01-04 |
| 1225456049 | Beth Anne Gielecki | Pharmacist | 22906 Lake Blvd, Saint Clair Shores, MI 48082-2727 | 2014-03-29 |
| 1013204635 | Muralidharan Kurup | Pharmacist | 24800 Harper Ave Ste 2, Saint Clair Shores, MI 48080-1292 | 2011-07-03 |
| 1508171638 | Rajshekhar H Shastri | Pharmacist | 25100 Harper Ave, Riteaid 4500, Saint Clair Shores, MI 48081-2207 | 2010-08-12 |
| 1730408865 | Blair Allen Willard | Pharmacist | 23201 Marter Rd, Saint Clair Shores, MI 48080-2729 | 2010-05-28 |
| 1881916773 | Raymond Todd Allard | Pharmacist | 22801 Harper Ave, Saint Clair Shores, MI 48080-1848 | 2010-02-19 |
| 1124631932 | Matthew Surducan | Pharmacist | 29520 Harper Ave, Saint Clair Shores, MI 48081-1211 | 2020-08-31 |
| 1396359113 | Kathleen Marie Bannatyne | Pharmacist | 29520 Harper Ave, Saint Clair Shores, MI 48081-1211 | 2020-08-31 |
| 1245856350 | Lamthy Quoc Vu | Pharmacist | 21211 Harper Ave, Saint Clair Shores, MI 48080-2208 | 2020-06-24 |
| 1972129310 | Rouba Metwele | Pharmacist | 21211 Harper Ave, Saint Clair Shores, MI 48080-2208 | 2020-06-22 |
| Find all providers in SAINT CLAIR SHORES | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48081 |
Please comment or provide details below to improve the information on MR. KENNETH MICHAEL BUSH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.