JENNIFER DAWN SHAFER (N.P.) – Family Nurse Practitioner, NPI 1366790776
Family Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
8,191 NURSE PRACTITIONER in IN
Provider Addresses for JENNIFER DAWN SHAFER (N.P.)
420 W LONGEST ST
PAOLI, IN 474548821
Phone: (812) 723-3944
Fax: (812) 723-7991
Type: Mailing
5604 E WHITE OAK LN
MARENGO, IN 471408413
Phone: (812) 365-3221
Fax: (812) 365-9502
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 66 Open Payments records for all available years, with a total value of $1,260.
Total Amount is formed as General ($1,260) + Research ($0) + Ownership ($0) = $1,260.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($268).
Total Amount
$1,260
General + Research + Ownership
Payments
66
Total payment records
General Amount
$1,260
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $268 |
| ABBVIE INC. | $201 |
| Takeda Pharmaceuticals U.S.A., Inc. | $65 |
| GlaxoSmithKline, LLC. | $49 |
| Abbott Laboratories | $48 |
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: 2013-01-29
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130129000555 | I | Nurse Practitioner | IN | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 95 | 76 | $0 |
| G0444 | Annual depression screening, 5 to 15 minutes | 37 | 37 | $0 |
| 83036 | Hemoglobin a1c level | 35 | 29 | $0 |
| 81003 | Automated urinalysis test | 12 | 11 | $0 |
Insurance plans in this area (ZIP 47454)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice, Sports Medicine | IN | |
| Certified Registered Nurse Anesthetist (Crna) | KY | |
| Family Practice | IN | |
| - | KY | |
| - | IN | |
| - | IN | |
| - | IN | |
| Nurse Practitioner | IN | |
| Family Practice | IN | |
| Orthopedic Surgery | IN |
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