Individual provider Active NPI

Kasey Bustamante

  • Family Nurse Practitioner
  • Dillon, SC
National Provider Identifier
1750089132
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28517 Issued in SC
Practice address
705 N 8TH Ave Ste 2B
Dillon, SC 29536-2549
Phone
(843) 841-3846
NPI assigned
Feb 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 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 28517 SC Primary

Addresses

Primary practice location

705 N 8TH Ave Ste 2B
Dillon, SC 29536-2549

Mailing address

705 N 8TH Ave Ste 2B
Dillon, SC 29536-2549

Other practice location 1

523 Camp Rd
Latta, SC 29565-4273
Phone (843) 627-2897

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20260306002735 SC Practitioner - Nurse Practitioner 0446732531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Practice addresses (Care Compare)

705 N 8TH Ave
Suite 2B
Dillon, SC 29536-2549
Phone (843) 841-3846

Hospital & facility affiliations

  • McLeod Medical Center - Dillon Hospital, Dillon, SC, CCN 420005
  • McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28517SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Physician Associates II CurrentSince Jan 25, 2026 Accepting new patients
McLeod Physician Associates II CurrentSince Jan 25, 2026 Accepting new patients
McLeod Physician Associates II Family Past Accepting new patients

Locations

705 N 8th Ave
Ste 2B
Dillon, SC 29536
Phone (843) 841-3846

Interoperability endpoints

  • Direct secure messaging: kbustamante24596@directmcleodehealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1750089132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 N 8TH AVE STE 2B",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295362549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 N 8TH AVE STE 2B",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295362549",
            "telephone_number": "843-841-3846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "523 Camp Rd",
            "address_purpose": "LOCATION",
            "city": "Latta",
            "state": "SC",
            "postal_code": "295654273",
            "country_code": "US",
            "telephone_number": "843-627-2897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "KASEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-16",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "28517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dillon, SC

Sources for this page

Verify at the official NPI Registry.