SHANNA K CARR (LICENSED DIETICIAN) – Registered Dietitian, NPI 1386730232
Registered Dietitian
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
113 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in MO
Provider Addresses for SHANNA K CARR (LICENSED DIETICIAN)
225 PHYSICIANS PARK STE 400
POPLAR BLUFF, MO 639013923
Phone: (573) 727-5500
Fax: (573) 727-5599
Type: Location
Jack in the Box, South 18th Street, Kansas City, Wyandotte County, Kansas, 66102, United States
KANSAS CITY, MO 641801143
Phone: (573) 331-5583
Fax: (573) 331-5079
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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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: 2005-09-09
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050909000780 | I | Registered Dietitian Or Nutrition Professional | MO | 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 |
|---|---|---|---|---|
| 97802 | Therapy procedure for nutrition management, each 15 minutes | 172 | 27 | $0 |
Insurance plans in this area (ZIP 63901)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MO | |
| - | MO | |
| - | MO | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MO | |
| Nurse Practitioner | MO | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal Medicine | MO | |
| General Surgery | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| - | MO |
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