MRS. SHANDA LYNNE PETTY (MSN, APRN, FNP-C) – Family Nurse Practitioner, NPI 1013668037

MRS. SHANDA LYNNE PETTY (MSN, APRN, FNP-C) is a healthcare provider. based in Sunset, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials MSN, APRN, FNP-C. They hold a License No. F08220790 (TX). The NPI Number for MRS. SHANDA LYNNE PETTY (MSN, APRN, FNP-C) is 1013668037

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
MRS. SHANDA LYNNE PETTY (MSN, APRN, FNP-C)
NPI
1013668037
Phone
(940) 255-6009
Address
2046 COUNTY ROAD 1790
Enumeration Date
11 January 2022
Last Update Date
15 September 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9402302580
Graduation Year
2016 (10 years ago)
PAC ID
6507241338
Group Practice PAC ID
9234553454
Professional Enrollment ID
I20220915000682
Address ID
TX762343646DE1705XFMXX302
Telehealth
Yes

Contacts

Other Endpoint
shandapetty@yahoo.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness85
Years active:4State licenses:1Other namesUpdated within 12 months

22,204 NURSE PRACTITIONER in TX

Provider Addresses for MRS. SHANDA LYNNE PETTY (MSN, APRN, FNP-C)

  • 2046 COUNTY ROAD 1790

    SUNSET, TX 762705331

    Phone: (940) 255-6009

    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)

CMS reports 9 Open Payments records for all available years, with a total value of $203.

Total Amount is formed as General ($203) + Research ($0) + Ownership ($0) = $203.

Last reported payment date: 2023-10-30 • Largest payer in this snapshot: Boston Scientific Corporation ($52).

Total Amount

$203

General + Research + Ownership

Payments

9

Total payment records

General Amount

$203

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-10-30

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2022-09-15

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
I20220915000682INurse PractitionerTXTBD

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 76270)

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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: 9234553454View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology)TX
Physician AssistantTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

Does MRS. SHANDA LYNNE PETTY (MSN, APRN, FNP-C) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MRS. SHANDA LYNNE PETTY (MSN, APRN, FNP-C) uses 1013668037.
Does CMS list MRS. SHANDA LYNNE PETTY (MSN, APRN, FNP-C) as active?
Yes — MRS. SHANDA LYNNE PETTY (MSN, APRN, FNP-C) is active in the NPI listing used on this page.
What is MRS. SHANDA LYNNE PETTY (MSN, APRN, FNP-C)'s primary classification?
Family Nurse Practitioner is the headline specialty for MRS. SHANDA LYNNE PETTY (MSN, APRN, FNP-C) here. Clinical services aligned with this taxonomy classification.
Where should I expect MRS. SHANDA LYNNE PETTY (MSN, APRN, FNP-C) on a map?
Expect Sunset, Texas as a primary anchor for MRS. SHANDA LYNNE PETTY (MSN, APRN, FNP-C) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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