Mrs Shanda Lynne Petty, MSN, APRN, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Sunset, Texas. Her current practice location is
2046 County Road 1790, Sunset, Texas. You can reach out to her office (for appointments etc.) via phone at
(940) 255-6009.
Mrs Shanda Lynne Petty is licensed to practice in Texas (license number F08220790) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1013668037.
Provider's Profile
Full Name | Mrs Shanda Lynne Petty |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 2046 County Road 1790, Sunset, Texas |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1013668037
- Provider Enumeration Date: 01/11/2022
- Last Update Date: 09/15/2022
Medicare PECOS Information:
- PECOS PAC ID: 6507241338
- Enrollment ID: I20220915000682
Medical Identifiers
Medical identifiers for Mrs Shanda Lynne Petty such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1013668037 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | F08220790 (Texas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Shanda Lynne Petty allows following entities to bill medicare on her behalf.
Entity Name | Epic Heart And Vascular Care Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1679198659 PECOS PAC ID: 9234553454 Enrollment ID: O20200721003385 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Shanda Lynne Petty is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Shanda Lynne Petty, MSN, APRN, FNP-C 2046 County Road 1790, Sunset, TX 76270-5331 Ph: (940) 255-6009 | Mrs Shanda Lynne Petty, MSN, APRN, FNP-C 2046 County Road 1790, Sunset, TX 76270-5331 Ph: (940) 255-6009 |
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