Shanda Lynne Petty, MSN, APRN, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Sunset, TX
NPI 1013668037 · NPPES record last updated Sep 15, 2022
Key facts
- NPI
- 1013668037
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F08220790 (TX)
- Practice address
- 2046 County Road 1790
Sunset, TX 76270-5331 - Phone
- (940) 255-6009
- NPI assigned
- Jan 11, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Epic Heart and Vascular Care PLLC
Practice addresses (Care Compare)
1705 S FM
51 Suite 107
Decatur, TX 76234-3646
Phone (940) 230-2580
8712 Medical City Way
Fort Worth, TX 76177-2414
Phone (817) 900-3000
Hospital & facility affiliations
- Medical City Denton
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220915000682 | TX | Practitioner - Nurse Practitioner | 6507241338 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F08220790 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epic Heart and Vascular Care PLLC | Current |
Accepting new patients |
Locations
1705 S FM 51
Ste 107
Decatur, TX 76234
Phone (940) 230-2580
8712 Medical City Way
Fort Worth, TX 76177
Phone (817) 900-3000
5801 Golden Triangle Blvd
Ste 103
Fort Worth, TX 76244
Phone (682) 356-2961
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IDDFCD/Endpoint/IDDFCD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F08220790 | TX | Yes |
Addresses
Primary practice location
2046 County Road 1790
Sunset, TX 76270-5331
Mailing address
2046 County Road 1790
Sunset, TX 76270-5331
Phone (940) 255-6009
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | shandapetty@yahoo.com |
Other providers in Sunset, TX
- Wendy Renee Fowler
- Jessica Hoffman
- Tonya Lynne King-Smith
- Pamela J Klein
- Ronal Scott Meador
- Denise Diane Wilkins
All providers in Sunset, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.