Individual provider Active NPI

Michele Bustard, APN

  • Family Nurse Practitioner
  • Mullica Hill, NJ
National Provider Identifier
1720591902
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00770500 Issued in NJ
Practice address
5 Myers Drive
Unit 104
Mullica Hill, NJ 08062
Phone
(856) 431-6300
Fax
(856) 431-6310
NPI assigned
Nov 10, 2017
Last updated
Mar 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00770500 NJ Primary

Addresses

Primary practice location

5 Myers Drive
Unit 104
Mullica Hill, NJ 08062

Mailing address

5 Myers Drive
Unit 104
Mullica Hill, NJ 08062
Phone (856) 431-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20180223000106 NJ Practitioner - Nurse Practitioner 2163783705 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fernandes Banerjee Shenoy Kidney Center,LLCGroup PAC ID 6204164262, 3 clinicians

Practice addresses (Care Compare)

5 Myers Dr
Suite 104
Mullica Hill, NJ 08062-9517
Phone (856) 431-6300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00770500NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Jersey Family Medical Centers, Inc. CurrentSince Jan 16, 2018 Accepting new patients
Signify Health Medical Associates of New Jersey, LLC CurrentSince Mar 1, 2023 Accepting new patients
Fernandes Banerjee Shenoy Kidney Center,LLC CurrentSince Jun 1, 2021 Accepting new patients
Southern Jersey Family Medical Centers, Inc CurrentSince Jan 16, 2018 Accepting new patients

Locations

1 N White Horse Pike
Hammonton, NJ 08037
Phone (609) 567-0200

860 S White Horse Pike
Hammonton, NJ 08037
Phone (609) 567-0200

5 Myers Dr
Ste 104
Mullica Hill, NJ 08062
Phone (856) 431-6300

5 Myers Dr
Ste 105
Mullica Hill, NJ 08062
Phone (856) 431-6300

116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 650-7800

238 E Broadway
Salem, NJ 08079
Phone (856) 935-7711

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/164776a0-ef92-46b0-b574-bc0e63ed9671/

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1720591902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MYERS DRIVE",
            "address_2": "UNIT 104",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "08062",
            "telephone_number": "856-431-6300",
            "fax_number": "856-431-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MYERS DRIVE",
            "address_2": "UNIT 104",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "08062",
            "telephone_number": "856-431-6300",
            "fax_number": "856-431-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTARD",
        "first_name": "MICHELE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-10",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00770500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mullica Hill, NJ

Sources for this page

Verify at the official NPI Registry.