SHONDA T CLARK (NP) – Nurse Practitioner, NPI 1114308251
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
Provider Addresses for SHONDA T CLARK (NP)
1600 Coit Rd Ste 104
Plano, TX 750756171
Phone: (972) 566-5411
Fax: (972) 519-8337
Type: Location
3125 HERITAGE BLVD
MATTESON, IL 604434450
Phone:
Type: Mailing
5841 S MARYLAND AVE
CHICAGO, IL 606371447
Phone: (773) 702-3844
Type: Location
1600 COIT RD STE 104
PLANO, TX 750756171
Phone: (972) 566-5411
Fax: (972) 519-8337
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.
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: 2021-09-24
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 |
|---|---|---|---|---|
| I20210924001671 | I | Nurse Practitioner | TX | 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 |
|---|---|---|---|---|
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 75075)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O L O G Y | WA | |
| N E U R O L O G Y | TX | |
| N E U R O L O G Y | TX | |
| N E U R O L O G Y | TX | |
| N E U R O L O G Y | TX | |
| Diagnostic Radiology, Interventional Radiology | MA | |
| Physician Assistant | OH | |
| Nurse Practitioner | TX | |
| Psychiatry, Neurology | TX | |
| Nurse Practitioner | TX |
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