Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Miss. Theresa Bushman, PHD, RD, LD

Individual provider Registered Dietitian · NPI 1295618353

Miss. Theresa Bushman, PHD, RD, LD is a Clinical Social Worker in Minneapolis, Minnesota. Qualified in 2024, 2 years ago. Licensed in Minnesota.

Years since qualifying
2
Licensed in
MN
In the registry since
2025
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.
RD — Registered Dietitian
A credentialed nutrition professional.
LD — Licensed Dietitian
A dietitian licensed by a state board.

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Practice location Address checks out

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone: (920) 883-5305
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 5683 (MN)

Record details

NPI number1295618353
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD , RD , LD
Sole proprietorNo
NPI enumeratedJuly 28, 2025
Last updated in NPPESJuly 28, 2025
Certification dateJuly 28, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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