Active NPI
Daysy Bustamante, RD
- Registered Dietitian
- Fort Worth, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 101 Summit Ave Ste 907
Fort Worth, TX 76102-2613 - Phone
- (469) 372-2022
- Fax
- (833) 290-5413
- NPI assigned
- Sep 13, 2023
- 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 Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
101 Summit Ave Ste 907
Fort Worth, TX 76102-2613
Mailing address
17060 Dallas Pkwy Ste 112
Dallas, TX 75248-1905
Phone (469) 372-2022
Other practice location 1
17060 Dallas Pkwy Ste 112
Dallas, TX 75248-1905
Phone (469) 372-2022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
17060 Dallas Pkwy
Suite 112
Dallas, TX 75248-1905
Phone (469) 372-2022
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doherty Nutrition LLC | Dietitian, Registered | Current | Accepting new patients |
Locations
650 Warrenville Rd
Ste 100
Lisle, IL 60532
Phone (331) 300-3102
17060 Dallas Pkwy
Ste 112
Dallas, TX 75248
Phone (469) 372-2022
101 Summit Ave
Ste 907
Fort Worth, TX 76102
Phone (817) 438-8044
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694563200000",
"number": "1437936200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17060 DALLAS PKWY STE 112",
"city": "DALLAS",
"state": "TX",
"postal_code": "752481905",
"telephone_number": "469-372-2022",
"fax_number": "833-290-5413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 SUMMIT AVE STE 907",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761022613",
"telephone_number": "469-372-2022",
"fax_number": "833-290-5413"
}
],
"practiceLocations": [
{
"address_1": "17060 Dallas Pkwy Ste 112",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752481905",
"country_code": "US",
"telephone_number": "469-372-2022",
"fax_number": "833-290-5413",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUSTAMANTE",
"first_name": "DAYSY",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-13",
"last_updated": "2023-09-13",
"certification_date": "2023-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.