Shanda Lynne Petty, MSN, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F08220790 Issued in TX

Practice address

2046 County Road 1790
Sunset, TX 76270-5331

Phone

(940) 255-6009

NPI assigned

Jan 11, 2022

Last updated

Sep 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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 PLLCGroup PAC ID 9234553454, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical City Denton Hospital, Denton, TX, CCN 450634

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IDDFCD/Endpoint/IDDFCD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Epic Heart and Vascular Care PLLC

  dba Epic Heart And Vascular Care

  • Interventional Cardiology Physician
  • Decatur, TX
  • NPI 1679198659
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Columbia Medical Center of Denton Subsidiary LP

  dba Medical City Denton

  • General Acute Care Hospital
  • Denton, TX
  • NPI 1306897277
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1013668037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2046 COUNTY ROAD 1790",
            "city": "SUNSET",
            "state": "TX",
            "postal_code": "762705331",
            "telephone_number": "940-255-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2046 COUNTY ROAD 1790",
            "city": "SUNSET",
            "state": "TX",
            "postal_code": "762705331",
            "telephone_number": "940-255-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "SHANDA",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F08220790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "shandapetty@yahoo.com",
            "affiliation": "N",
            "address_1": "2046 County Road 1790",
            "city": "Sunset",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762705331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wendy Renee Fowler, LM, CPM
• Jessica Hoffman
• Tonya Lynne King-Smith, LCSW
• Pamela J Klein, MS-HNFM, CNS-CANIDAT
• Ronal Scott Meador
• Denise Diane Wilkins

• Family Nurse Practitioner in Sunset, TX
• Providers in Sunset, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.