Chechelle Marie Tablang Bustamante, FNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

R172810 Issued in MD

Practice address

18409 Shady View LN
Brookeville, MD 20833-2842

Phone

(301) 273-5195

NPI assigned

Jun 24, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

American Medical Missionary College, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medstar Urgent Care LLCGroup PAC ID 9335303155, shared by 36 NPIs, 300 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Medstar Urgent Care LLC

  • Urgent Care Clinic/Center
  • Baltimore, MD
  • NPI 1902175870
  Medicare reassignment NPD
• Medstar Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Wheaton, MD
  • NPI 1871843409

  DC

  Medicare reassignment NPD
• Zeus Primary Care Associates LLC

  • Internal Medicine Physician
  • Rockville, MD
  • NPI 1457973026

  DC

  Medicare reassignment
• Medstar Urgent Care LLC

  • General Practice Physician
  • Lexington Park, MD
  • NPI 1275410474
  NPD
• Medstar Urgent Care LLC

  • Urgent Care Clinic/Center
  • Baltimore, MD
  • NPI 1942623319
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1487850715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18409 SHADY VIEW LN",
            "city": "BROOKEVILLE",
            "state": "MD",
            "postal_code": "208332842",
            "telephone_number": "301-273-5195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18409 SHADY VIEW LN",
            "city": "BROOKEVILLE",
            "state": "MD",
            "postal_code": "208332842",
            "telephone_number": "301-273-5195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "CHECHELLE MARIE",
        "middle_name": "TABLANG",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-24",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R172810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Susan Anglin, SLP
• Kathleen Bachiochi, MS, CCC - SLP
• Richard J. Bertin, RPH, PHD
• Maribeth Mulsid Bugash
• Eric Matthew Button
• Tiera Chenault
• Alissa Joy Dalgewicz Cole
• Aislinn Cunningham, RBT
• Jason B Deitz

• Primary Care Nurse Practitioner in Brookeville, MD
• Providers in Brookeville, MD by specialty
• Primary Care Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.