SHAVON PRENTICE (APRN) – Family Nurse Practitioner, NPI 1962782128
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for SHAVON PRENTICE (APRN)
PO BOX 3299
CARSON CITY, NV 897023299
Phone: (775) 222-0044
Fax: (888) 700-0187
Type: Mailing
828 LANE ALLEN RD STE 219
LEXINGTON, KY 40504
Phone: (502) 498-4071
Fax: (888) 423-5216
Type: Location
5743 PRESTON HWY
LOUISVILLE, KY 402191305
Phone: (502) 444-6008
Fax: (502) 586-7173
Type: Location
PO BOX 740012
ATLANTA, GA 303740012
Phone:
Type: Mailing
PO BOX 950244
LOUISVILLE, KY 402950244
Phone: (502) 953-4700
Type: Mailing
2215 PORTLAND AVE
LOUISVILLE, KY 402121033
Phone: (502) 774-8631
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $54.
Total Amount is formed as General ($54) + Research ($0) + Ownership ($0) = $54.
Last reported payment date: 2023-12-21 • Largest payer in this snapshot: Abbott Laboratories ($23).
Total Amount
$54
General + Research + Ownership
Payments
3
Total payment records
General Amount
$54
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-12-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $23 |
| Neurocrine BioSciences, Inc. | $17 |
| GlaxoSmithKline, LLC. | $14 |
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: 2012-03-23
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 |
|---|---|---|---|---|
| I20120323000276 | I | Nurse Practitioner | KY | 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 |
|---|---|---|---|---|
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 112 | 43 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 25 | 25 | $0 |
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 23 | 23 | $0 |
| 81002 | Urinalysis, manual test | 18 | 17 | $0 |
| G0008 | Administration of influenza virus vaccine | 16 | 14 | $0 |
Insurance plans in this area (ZIP 89702)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | PA | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| - | KY | |
| Nurse Practitioner | KY | |
| - | KY | |
| Clinical Social Worker | KY | |
| O B S T E T R I C S/ G Y N E C O L O G Y | KY | |
| Clinical Social Worker | KY | |
| Family Practice | KY |
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