DR. MAYRA S. BUSTILLO (NPI# 1740231430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740231430 |
| Entity Type | Individual |
| Full Name | DR. MAYRA S. BUSTILLO |
| Credential | M.D. |
| Practice Address |
1115 Weber St Franklin LA 70538-4124 |
| Practice Telephone | 3378282550 |
| Practice Fax Number | 3373552335 |
| Mailing Telephone | 3378282550 |
| Mailing Fax Number | 3373552335 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2019-02-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0214X |
Pediatrics Specialization: Pediatric Pulmonology |
12129R | LA | Allopathic & Osteopathic Physicians |
| N | 2080P0214X |
Pediatrics Specialization: Pediatric Pulmonology |
L6308 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1533467 | 05 | |
| TX | 081278601 | 05 |
| Street Address |
1115 WEBER ST |
| City | FRANKLIN |
| State | LA |
| Zip Code | 70538-4124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952303240 | Chakshu Gautam | Family Medicine | 1115 Weber St, Teche Action Clinic, Franklin, LA 70538-4124 | 2005-06-01 |
| 1326655952 | Brian Gregory Serio | Nurse Practitioner | 1115 Weber St, Franklin, LA 70538-4124 | 2020-09-28 |
| 1346873403 | Alexis Bourgeois | Nurse Practitioner | 1115 Weber St, Franklin, LA 70538-4124 | 2020-02-18 |
| 1396226767 | Carolyn Higdon | Counselor | 1115 Weber St, Franklin, LA 70538-4124 | 2018-08-23 |
| 1033627906 | Emily Geesling Bergeron | Nurse Practitioner | 1115 Weber St, Franklin, LA 70538 | 2018-01-13 |
| 1801314315 | Eden Desiree Etcheverria | Physician Assistant | 1115 Weber St, Franklin, LA 70538-4124 | 2017-09-05 |
| 1245760800 | Shayla Lux Autrey | Nurse Practitioner | 1115 Weber St, Franklin, LA 70538-4124 | 2017-06-15 |
| 1003354929 | Jamila Mckinnis Riley | Dentist | 1115 Weber St, Franklin, LA 70538 | 2017-02-11 |
| 1790140549 | Crystal Hill | Nurse Practitioner | 1115 Weber St, Franklin, LA 70538-4124 | 2015-12-21 |
| 1942608997 | Tangela Denise Robertson | Nurse Practitioner | 1115 Weber St, Franklin, LA 70538-4124 | 2014-12-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154790327 | Bogalusa Rehabilitation Hospital LLC | Rehabilitation Hospital | 604 Palfrey Street, Franklin, LA 70538 | 2015-09-17 |
| 1720325855 | Thomas Frere Kramer | Obstetrics & Gynecology | 4484 Irish Bend Rd., Franklin, LA 70538 | 2013-01-09 |
| 1073797098 | Jaba Enterprises Inc | Home Health | 1101 Northwest Blvd, Franklin, LA 70538 | 2007-12-27 |
| 1578784195 | Jeffrey Neil Jordan | Clinic/Center | 1600 Hospital Avenue, Franklin, LA 70538 | 2007-05-01 |
| 1508948852 | Kira P Ridgley | Physician Assistant | 1105 Northwest Blvd., Franklin, LA 70538 | 2006-10-19 |
| 1871602581 | John Neal Boudreaux | Dentist | 600 Haifleigh St, Franklin, LA 70538 | 2006-08-29 |
| 1891273850 | Demetra Smith | Case Manager/Care Coordinator | 75 Main St, Franklin, LA 70538 | 2018-08-01 |
| 1497244891 | Ashley Burkhart | Counselor | 75 Main St, Franklin, LA 70538 | 2018-05-02 |
| 1710474036 | Fallon Hoskins-august | Case Manager/Care Coordinator | 75 Main St, Franklin, LA 70538 | 2018-04-23 |
| 1275035032 | Earolyn Ann Choate | Case Manager/Care Coordinator | 75 Main St, Franklin, LA 70538 | 2018-03-07 |
| Find all providers in zip 70538 | ||||
| Taxonomy Code | 2080P0214X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Pulmonology |
| A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780633248 | Michael Kiernan | Pediatrics | 4720 S. I-10 Service Rd. West, Ste 101, Metairie, LA 70001 | 2006-05-10 |
| 1871561241 | Adrienne Prestirdge Savant | Pediatrics | 1430 Tulane Ave Dept Of, New Orleans, LA 70112-2632 | 2006-03-10 |
| 1477526598 | Stephen D Levine | Pediatrics | 120 Innwood Dr, Covington, LA 70433-9123 | 2006-02-09 |
| 1205836558 | David E Thomas | Pediatrics | 2355 Drusilla Ln, Baton Rouge, LA 70809-1443 | 2005-07-28 |
| 1508863002 | Eduardo J Hernandez | Pediatrics | 1430 Lindberg Dr, Slidell, LA 70458-8056 | 2005-06-30 |
| 1376910240 | Wk Pediatric Pulmonology Specialists | Pediatrics | 2530 Bert Koun Loop, Suite 114, Shreveport, LA 71118-3132 | 2015-08-27 |
| 1518354224 | Sasikumar Kilaikode Cheruveettara | Pediatrics | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2015-04-20 |
| 1972873545 | William W Waring Sr. | Pediatrics | 123 Walnut St, #905, New Orleans, LA 70118-4847 | 2012-01-12 |
| 1306164926 | Andres Carrion- Vargas | Pediatrics | 7777 Hennessy Blvd, Suite 406, Baton Rouge, LA 70808-4300 | 2010-05-06 |
| 1235263724 | Our Lady of The Lake Regional Medical Center | Pediatrics | 8415 Goodwood Blvd, Suite 105, Baton Rouge, LA 70806-7851 | 2007-03-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.