Individual provider Active NPI

Jessica T Bustos, ANP, RN

  • Adult Health Nurse Practitioner
  • Pinehurst, NC
National Provider Identifier
1619175791
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
304681 Issued in NY
Practice address
285 Olmsted Blvd
Suite 1
Pinehurst, NC 28374-8731
Phone
(910) 295-7246
Fax
(910) 222-3168
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 304681 NY Primary

Addresses

Primary practice location

285 Olmsted Blvd
Suite 1
Pinehurst, NC 28374-8731

Mailing address

285 Olmsted Blvd
Suite 1
Pinehurst, NC 28374-8731
Phone (910) 295-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20160229001291 NC Practitioner - Nurse Practitioner 6901107051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Solas Health PLLCGroup PAC ID 7315915469, 13 clinicians

Practice addresses (Care Compare)

285 Olmsted Blvd
Suite 1
Pinehurst, NC 28374-9021
Phone (910) 295-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Solas Health PLLC CurrentSince Dec 22, 2015 Accepting new patients
Pinehurst OBGYN Associates PA PastSince Dec 22, 2015 Accepting new patients
Spectrum Recovery Inc PastSince Nov 13, 2017 Accepting new patients

Locations

2911 Breezewood Ave
Ste 101
Fayetteville, NC 28303
Phone (910) 677-9488

4308 Ludgate St
Lumberton, NC 28358
Phone (910) 671-9298

285 Olmsted Blvd
Ste 1
Pinehurst, NC 28374
Phone (910) 295-7246

8001 Creedmoor Rd
Ste 107
Raleigh, NC 27613
Phone (919) 460-7246

201 Commercial Ct
Sanford, NC 27330
Phone (910) 295-7246

Interoperability endpoints

  • Direct secure messaging: jbustos@pinehurst.curemd.direct-ci.com

Organizations & group practices 3

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1619175791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 OLMSTED BLVD",
            "address_2": "SUITE 1",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748731",
            "telephone_number": "910-295-7246",
            "fax_number": "910-222-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 OLMSTED BLVD",
            "address_2": "SUITE 1",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748731",
            "telephone_number": "910-295-7246",
            "fax_number": "910-222-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTOS",
        "first_name": "JESSICA",
        "middle_name": "T",
        "credential": "ANP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "304681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.