Jamie Leigh Bustamante, PHD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

102501922501 Issued in UT

Practice address

409 W 400 S
Salt Lake City, UT 84101-1135

Phone

(801) 364-0058

NPI assigned

Mar 12, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21160/brand/1/csg/1/fhir/r4
• Direct secure messaging: jamie.bustamantephd.p1@direct.tgcaz.nextgenshare.com

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.

• Kindly MD, Inc.

  • General Practice Physician
  • Millcreek, UT
  • NPI 1225647480
  Medicare reassignment NPD
• Transformative Care

  • Counseling Psychologist
  • Salt Lake City, UT
  • NPI 1649891953
  NPD Authorized official

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1982097127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 E 300 S STE 6",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022332",
            "telephone_number": "018-618-0852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W 400 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841011135",
            "telephone_number": "801-364-0058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 E 300 S Ste 6",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841022332",
            "country_code": "US",
            "telephone_number": "801-618-0852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "JAMIE",
        "middle_name": "LEIGH",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-12",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "4602",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "UT",
            "license": "102501922501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982097127",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20504",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shylo Lane Mower Bushey
• Kade Degen Bushman
• Kaitlyn Bushman
• Boston Bushnell
• Lowry A Bushnell, MD
• Magdalena Bustamante
• Martin Richard Buta, M.D.
• Andrew Butcher, LCSW
• Brooke Butcher
• Jessica Buter

• Counseling Psychologist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Counseling Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.