Active NPI
Aurora Bustillos, RNC-MNN, IBCLC
- Lactation Consultant (Registered Nurse)
- Fort Worth, TX
National Provider Identifier
1891080404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lactation Consultant (Registered Nurse)
- License
- 578013
- Practice address
- 1201 S Main St
Fort Worth, TX 76104-4804 - Phone
- (817) 702-7524
- Fax
- (817) 920-6596
- NPI assigned
- Jun 10, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Registered Nurse) | 163WL0100X | 578013 | TX | Primary |
Addresses
Primary practice location
1201 S Main St
Fort Worth, TX 76104-4804
Mailing address
1500 S Main St
Fort Worth, TX 76104-4917
Phone (817) 702-7524
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BUS1-0429-7211 | Other | TX | NCC |
| 578013 | Other | TX | BOARD OF NURSE EXAMINERS |
| 10920319 | Other | TX | IBLCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 578013 | TX | MD | Lactation Consultant (Registered Nurse) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414022400000",
"number": "1891080404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 S MAIN ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761044917",
"telephone_number": "817-702-7524",
"fax_number": "817-920-6596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 S MAIN ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761044804",
"telephone_number": "817-702-7524",
"fax_number": "817-920-6596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSTILLOS",
"first_name": "AURORA",
"name_prefix": "Mrs.",
"credential": "RNC-MNN, IBCLC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-10",
"last_updated": "2014-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "163WL0100X",
"taxonomy_group": "",
"desc": "Registered Nurse, Lactation Consultant",
"state": "TX",
"license": "578013",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCC",
"identifier": "BUS1-0429-7211",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF NURSE EXAMINERS",
"identifier": "578013",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IBLCE",
"identifier": "10920319",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.