Active NPI
Yesica Bustos-Moran
- Registered Record Administrator
- Medford, OR
National Provider Identifier
1124686167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Record Administrator
- License
- THW000003305
- Practice address
- 300 W Main St
Medford, OR 97501-2756 - Phone
- (541) 772-1777
- Fax
- (541) 734-2410
- NPI assigned
- Jun 4, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Record Administrator | 246YR1600X | THW000003305 | OR | Primary |
Addresses
Primary practice location
300 W Main St
Medford, OR 97501-2756
Mailing address
300 W Main St
Medford, OR 97501-2756
Phone (541) 772-1777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| THW000003305 | OR | MD | Registered Record Administrator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559606400000",
"number": "1124686167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W MAIN ST",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975012756",
"telephone_number": "541-772-1777",
"fax_number": "541-734-2410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W MAIN ST",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975012756",
"telephone_number": "541-772-1777",
"fax_number": "541-734-2410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSTOS-MORAN",
"first_name": "YESICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-04",
"last_updated": "2019-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "246YR1600X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Health Information, Registered Record Administrator",
"state": "OR",
"license": "THW000003305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.