SHAVONNE LARCENIA OVERTON – Family Nurse Practitioner, NPI 1922713254

SHAVONNE LARCENIA OVERTON is a healthcare provider. based in Bridgeport, Connecticut. specializing in NURSE PRACTITIONER. They hold a License No. 12.011424 (CT). The NPI Number for SHAVONNE LARCENIA OVERTON is 1922713254

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
SHAVONNE LARCENIA OVERTON
NPI
1922713254
Phone
(860) 680-2922
Address
58 Tully Cir
Enumeration Date
20 January 2023
Last Update Date
17 April 2025

Doctor Profile

Medical School Name
DREXEL UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
2034043463
Graduation Year
2022 (4 years ago)
PAC ID
4688047947
Group Practice PAC ID
7810428166
Professional Enrollment ID
I20240409004270
Address ID
CT065151405NE158XXRDXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

4,191 NURSE PRACTITIONER in CT

Provider Addresses for SHAVONNE LARCENIA OVERTON

  • 58 Tully Cir

    Bridgeport, CT 066101116

    Phone: (860) 680-2922

    Type: Location

  • PO BOX 745254

    ATLANTA, GA 303745254

    Phone: (773) 352-1515

    Type: Mailing

  • 158 AMITY RD # 280

    NEW HAVEN, CT 065151405

    Phone: (203) 404-3463

    Fax: (203) 563-9255

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $24.

Total Amount is formed as General ($24) + Research ($0) + Ownership ($0) = $24.

Last reported payment date: 2024-10-24 • Largest payer in this snapshot: Neurocrine BioSciences Inc. ($24).

Total Amount

$24

General + Research + Ownership

Payments

1

Total payment records

General Amount

$24

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-24

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-04-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240409004270INurse PractitionerCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06610)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7810428166View full group profile
NameSpecialtyState
Nurse PractitionerCT
Family PracticeCT
Family PracticeNY
Internal MedicineNE
Internal MedicineCT
Nurse PractitionerOR

Reviews

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Frequently asked questions

What NPI should I save for SHAVONNE LARCENIA OVERTON?
Save NPI 1922713254 if you need a stable reference for SHAVONNE LARCENIA OVERTON.
Is SHAVONNE LARCENIA OVERTON currently active in the NPI registry?
CMS-published data lists SHAVONNE LARCENIA OVERTON as an active registrant.
Can you summarize SHAVONNE LARCENIA OVERTON's specialty in plain language?
Clinically, the directory lists SHAVONNE LARCENIA OVERTON with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for SHAVONNE LARCENIA OVERTON?
The page summarizes Bridgeport, Connecticut for SHAVONNE LARCENIA OVERTON; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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