SHAWTA SACKETT (PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1073099875

SHAWTA SACKETT (PMHNP-BC) is a healthcare provider. based in Moses lake, Washington. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP-BC. They hold a License No. AP60867849 (WA). The NPI Number for SHAWTA SACKETT (PMHNP-BC) is 1073099875

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
SHAWTA SACKETT (PMHNP-BC)
NPI
1073099875
Phone
(253) 653-3864
Address
1017 W Ivy Ave
Enumeration Date
14 July 2018
Last Update Date
28 August 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5097876423
Graduation Year
2018 (8 years ago)
PAC ID
3375895113
Group Practice PAC ID
1254235138
Professional Enrollment ID
I20181005002708
Address ID
WA988481695QU1450XSWXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

6,261 NURSE PRACTITIONER in WA

Provider Addresses for SHAWTA SACKETT (PMHNP-BC)

  • 1017 W Ivy Ave

    Moses Lake, WA 988372048

    Phone: (253) 653-3864

    Type: Location

  • 605, South Coolidge Street, Moses Lake, Grant County, Washington, 98837, United States

    MOSES LAKE, WA 988371893

    Phone: (509) 765-0674

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 23 Open Payments records for all available years, with a total value of $548.

Total Amount is formed as General ($548) + Research ($0) + Ownership ($0) = $548.

Last reported payment date: 2024-11-22 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($169).

Total Amount

$548

General + Research + Ownership

Payments

23

Total payment records

General Amount

$548

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-22

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: 2018-10-05

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
I20181005002708INurse PractitionerWATBD

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 98837)

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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: 1254235138View full group profile
NameSpecialtyState
Physician AssistantWA
Diagnostic RadiologyMT
Family PracticeWA
Obstetrics/Gynecology, Family PracticeWA
Clinical Social WorkerWA
Internal Medicine, HospitalistWA
Nurse PractitionerWA
Diagnostic RadiologyWA
Obstetrics/Gynecology, Family PracticeWA
Physician AssistantWA

Reviews

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Frequently asked questions

How is SHAWTA SACKETT (PMHNP-BC) identified in CMS data?
CMS-hosted NPPES data lists SHAWTA SACKETT (PMHNP-BC) with NPI 1073099875.
Is SHAWTA SACKETT (PMHNP-BC) still practicing?
SHAWTA SACKETT (PMHNP-BC) is currently listed as active in the public NPI registry.
What taxonomy line describes SHAWTA SACKETT (PMHNP-BC)?
For research purposes, treat SHAWTA SACKETT (PMHNP-BC) as Psychiatric/Mental Health Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Where is SHAWTA SACKETT (PMHNP-BC) based?
SHAWTA SACKETT (PMHNP-BC) is tied to Moses Lake, Washington in the data we show; additional addresses may exist on the full record.
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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