CMS-1500 Box 24J / 33a • NPI
1093950941
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207VG0400X (CMS 16)
Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor)
Box 32 Service Location & ZIP+4
1700 HENRY LUCKOW LN, BELVIDERE, IL, 61008
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1093950941 (AMANDA JO BUSH, M.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1093950941 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | AMANDA JO BUSH, M.D. |
| Plain-English Specialty | Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor) NUCC Code: 207VG0400X (Obstetrics & Gynecology, Gynecology) |
| Certifying / Licensing Body | American Board of Obstetrics and Gynecology (ABOG) |
| Practice Location Address | 1700 HENRY LUCKOW LN, BELVIDERE, IL, 61008 |
| Practice Telephone / Fax | Tel: (779) 696-8650 |
| Administrative Mailing Address | PO BOX 78866 SWEDISHAMERICAN MEDICAL GROUP, MILWAUKEE, WI, 53278-8866 |
| Enumeration & Last Sync | Enumerated: 2008-12-06 | CMS Record Updated: 2024-01-03 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (207VG0400X)
What Does Taxonomy Code 207VG0400X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207VG0400X translates to:
"Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (AMANDA JO BUSH, M.D.)
Typical CPT / Diagnostic Procedures:- Comprehensive Antenatal Care, Fetal Ultrasound & Labor/Delivery
- Cervical Cytology (Pap Smear), HPV Co-Testing & Colposcopy
- Pelvic Ultrasound & Minimally Invasive Laparoscopic Hysterectomy/Myomectomy
- Prenatal Folic Acid, Iron & Progesterone Supplementation
- Combined Oral Contraceptives, Levonorgestrel IUDs & Hormone Therapy
- Fluconazole, Metronidazole & Pregnancy-Safe Beta-Lactam Antibiotics (Ampicillin)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207V00000X — Obstetrics & GynecologyPlain English: Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor) | State: TX | License: n3526 | Primary: Secondary |
207VG0400X — Obstetrics & Gynecology, GynecologyPlain English: Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor) | State: MA | License: MB0755263A | Primary: Secondary |
207VG0400X — Obstetrics & Gynecology, GynecologyPlain English: Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor) | State: IL | License: 036.125964 | Primary: Secondary |
207VG0400X — Obstetrics & Gynecology, GynecologyPlain English: Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor) | State: TX | License: N3526 | Primary: Yes (Primary) |
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