Kathleen Bustamante Viado Erezo, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024170340 Issued in VA

Practice address

1925 Glenn Mitchell Dr Ste 202
Virginia Beach, VA 23456-0177

Phone

(757) 507-0900

Fax

(757) 301-6462

NPI assigned

Dec 3, 2012

Last updated

Mar 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kathleen Bustamante Viado Former name

Medicare fee-for-service enrollment

Enrolled in VA

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 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
• Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
• Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
• Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sentara Hospitals

  dba Sentara Nightingale

  • Air Ambulance
  • Norfolk, VA
  • NPI 1235205147

  Hospital

  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Norfolk General Hospital

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1437119310
  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Virginia Beach General Hospital

  • General Acute Care Hospital
  • Virginia Beach, VA
  • NPI 1629038336
  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Leigh Hospital

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1811957681
  Care Compare affiliation
• Sentara Princess Anne Hospital

  • General Acute Care Hospital
  • Virginia Beach, VA
  • NPI 1528028396
  Care Compare affiliation

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1548505563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 GLENN MITCHELL DR STE 202",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560177",
            "telephone_number": "757-507-0900",
            "fax_number": "757-301-6462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 GLENN MITCHELL DR STE 202",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560177",
            "telephone_number": "757-507-0900",
            "fax_number": "757-301-6462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "855 W Brambleton Ave",
            "address_2": "EVMS Medical Group",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235101005",
            "country_code": "US",
            "telephone_number": "757-446-5908",
            "fax_number": "757-446-7055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EREZO",
        "first_name": "KATHLEEN",
        "middle_name": "BUSTAMANTE VIADO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-03",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024170340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "VIADO",
            "middle_name": "BUSTAMANTE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.