CMS-1500 Box 24J / 33a • NPI
1013668037
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LF0000X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family
Box 32 Service Location & ZIP+4
2046 COUNTY ROAD 1790, SUNSET, TX, 76270-5331
✓ 9-Digit EDI 837 ZIP+4 (76270-5331)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1013668037 (SHANDA LYNNE PETTY, MSN, APRN, FNP-C) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1013668037)
Medicare Beneficiaries
343
Total Billed Services
1,017
Distinct CPT/HCPCS Codes
23
Medicare Allowed Total
$105,673.65
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 44 |
99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 39 |
99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 736 |
99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | 121 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Amiodarone Hcl Amiodarone Hcl | 13 | <11 |
| Amlodipine Besylate Amlodipine Besylate | 239 | 82 |
| Atorvastatin Calcium Atorvastatin Calcium | 349 | 129 |
| Bisoprolol Fumarate Bisoprolol Fumarate | 18 | <11 |
| Brilinta Ticagrelor | 139 | 53 |
| Bumetanide Bumetanide | 11 | <11 |
| Carvedilol Carvedilol | 741 | 226 |
| Chlorthalidone Chlorthalidone | 19 | <11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1013668037 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | SHANDA LYNNE PETTY, MSN, APRN, FNP-C |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family NUCC Code: 363LF0000X (Nurse Practitioner, Family) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 2046 COUNTY ROAD 1790, SUNSET, TX, 76270-5331 |
| Practice Telephone / Fax | Tel: (940) 255-6009 |
| Administrative Mailing Address | 2046 COUNTY ROAD 1790, SUNSET, TX, 76270-5331 |
| Enumeration & Last Sync | Enumerated: 2022-01-11 | CMS Record Updated: 2022-09-15 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LF0000X)
What Does Taxonomy Code 363LF0000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LF0000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (SHANDA LYNNE PETTY, MSN, APRN, FNP-C)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363LF0000X — Nurse Practitioner, FamilyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family | State: TX | License: F08220790 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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