SHONNA BACK (NURSE PRACTITIONER) – Family Nurse Practitioner, NPI 1376734442
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,347 NURSE PRACTITIONER in KY
Provider Addresses for SHONNA BACK (NURSE PRACTITIONER)
3955 Alexandria Pike
Cold Spring, KY 410762027
Phone: (859) 442-8700
Fax: (859) 442-8718
Type: Location
Pavilion, Friars Road, St. Woolos, Stow Hill, Newport, Gwent, Wales, NP20, United Kingdom
NEWPORT, KY 410712998
Phone: (859) 652-7203
Fax: (859) 652-7204
Type: Location
108, Woodland Drive, Elizabethtown, Bladen County, North Carolina, 28337, United States
ELIZABETHTOWN, KY 427012770
Phone: (270) 765-4535
Fax: (270) 763-1901
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $238.
Total Amount is formed as General ($238) + Research ($0) + Ownership ($0) = $238.
Last reported payment date: 2024-03-04 • Largest payer in this snapshot: ABBVIE INC. ($238).
Total Amount
$238
General + Research + Ownership
Payments
2
Total payment records
General Amount
$238
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $238 |
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: 2025-09-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20100722000811 | I | Nurse Practitioner | KY | TBD |
| I20250925003781 | I | Nurse Practitioner | OH | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 41076)
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