ANDREA DAWN SHOTTON (MS RD LD) – Registered Dietitian, NPI 1184851255

ANDREA DAWN SHOTTON (MS RD LD) is a healthcare provider. based in Broken arrow, Oklahoma. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold the professional credentials MS RD LD. They hold a License No. 1371 (TN). The NPI Number for ANDREA DAWN SHOTTON (MS RD LD) is 1184851255

Main info

Female
Sole Proprietor
26 Years Of Experience
Accepts Medicare Assignment
Name
ANDREA DAWN SHOTTON (MS RD LD)
NPI
1184851255
Phone
(918) 449-1123
Address
21333 E 104TH ST
Enumeration Date
16 June 2009
Last Update Date
12 February 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9185872171
Graduation Year
2000 (26 years ago)
PAC ID
6204982069
Group Practice PAC ID
1951297621
Professional Enrollment ID
I20090918000477
Address ID
OK741065907TU1334XAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:16State licenses:2Digital endpointsOther names

106 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in OK

Provider Addresses for ANDREA DAWN SHOTTON (MS RD LD)

  • 21333 E 104TH ST

    BROKEN ARROW, OK 740143669

    Phone: (918) 449-1123

    Mailing address matches the actual address.

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.

This can happen when there are no reportable CMS Open Payments records.

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: 2009-09-18

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
I20090918000477IRegistered Dietitian Or Nutrition ProfessionalOKTBD

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 74014)

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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: 1951297621View full group profile
NameSpecialtyState
-OK
Family PracticeOK
Mental Health CounselorOK
P S Y C H I A T R YOK
Mental Health CounselorOK
Clinical Social WorkerOK
Family PracticeOK
Physician AssistantOK
Mental Health CounselorOK
Physician AssistantOK

Reviews

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Frequently asked questions

What is ANDREA DAWN SHOTTON (MS RD LD)'s NPI number?
ANDREA DAWN SHOTTON (MS RD LD)'s NPI is 1184851255 — the number used across U.S. healthcare to identify this provider.
Is ANDREA DAWN SHOTTON (MS RD LD) shown as active in public data?
Registry records indicate ANDREA DAWN SHOTTON (MS RD LD) maintains an active NPI.
What kind of doctor is ANDREA DAWN SHOTTON (MS RD LD)?
ANDREA DAWN SHOTTON (MS RD LD) is associated with Registered Dietitian in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for ANDREA DAWN SHOTTON (MS RD LD)?
Travel planning: use Broken Arrow, Oklahoma as the reference point for ANDREA DAWN SHOTTON (MS RD LD), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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