KACI BLACKSHEAR – Registered Dietitian, NPI 1154194876
Registered Dietitian
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for KACI BLACKSHEAR
85 Ih 10 N Ste 112
Beaumont, TX 777072560
Phone: (409) 239-5139
Fax: (409) 347-8856
Type: Location
85 Ih 10 N Ste 208
Beaumont, TX 777072539
Phone: (409) 842-1112
Fax: (409) 840-4104
Type: Location
2400 Highway 365 Ste 112
Nederland, TX 776276268
Phone: (409) 724-7900
Fax: (409) 724-7910
Type: Location
403 S Magnolia St
Woodville, TX 759795238
Phone: (409) 283-2888
Fax: (409) 283-2892
Type: Location
515 S Archie St
Vidor, TX 776624868
Phone: (409) 769-2295
Fax: (409) 769-3373
Type: Location
2400 Highway 365 Ste 208
Nederland, TX 776276250
Phone: (409) 730-8054
Fax: (409) 226-3374
Type: Location
538 BROADWAY
WINNIE, TX 776657600
Phone: (409) 296-6000
Fax: (409) 296-6372
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2024-03-04
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 |
|---|---|---|---|---|
| I20240304002721 | I | Registered Dietitian Or Nutrition Professional | 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 77707)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.