DANISE A PETTICREW (RN, FNP-C) – Family Nurse Practitioner, NPI 1952359200
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
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Provider Addresses for DANISE A PETTICREW (RN, FNP-C)
1133, Medical Drive, Tyler, Smith County, Texas, 75701, United States
TYLER, TX 757012130
Phone: (903) 595-5486
Fax: (903) 595-0206
Type: Mailing
635, Stone Avenue, Paris, Lamar County, Texas, 75460, United States
PARIS, TX 754609342
Phone: (903) 785-3300
Fax: (903) 785-3310
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $81.
Total Amount is formed as General ($81) + Research ($0) + Ownership ($0) = $81.
Last reported payment date: 2024-09-26 • Largest payer in this snapshot: Lilly USA, LLC ($81).
Total Amount
$81
General + Research + Ownership
Payments
1
Total payment records
General Amount
$81
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $81 |
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: 2011-09-07
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 |
|---|---|---|---|---|
| I20110907001173 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 75701)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | TX | 90966 | Home dialysis services per month, patient 20 years of age or older | 22 | 13 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX | |
| Nurse Practitioner | AK | |
| Physician Assistant | AK | |
| Physician Assistant | AK | |
| - | AK | |
| Nurse Practitioner | AK | |
| Physician Assistant | AK | |
| - | AK | |
| Physical Therapist In Private Practice | HI | |
| Nurse Practitioner | AK |
Reviews
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