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SHANE DAVID STATHAM
NPI 1902422603
Nurse Practitioner - Family in Wichita Falls, TX

Active since June 18, 2020PECOS EnrolledAccepts Medicare Assignment
66.74/100
CMS Quality Rating
5800 KELL BLVD STE 500, WICHITA FALLS, TX 76310(940) 260-8976(888) 510-8976 Get Directions Write a Review

NPPES record last updated: October 23, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 24, 2021, Jun 18, 2020 (2 updates tracked since 2020).

About Shane David Statham NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANE DAVID STATHAM (NPI 1902422603) is an individual family provider in Wichita Falls, Texas, licensed in Texas (1017571) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS, is affiliated with United Regional Health Care System, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1902422603
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameSHANE DAVID STATHAM
Location Address5800 KELL BLVD STE 500Wichita Falls, TX 76310-1618
Mailing Address5800 Kell Blvd Ste 500Wichita Falls, TX 76310-1618 · (940) 260-8976 · Fax (888) 510-8976
Phone(940) 260-8976
Fax(888) 510-8976
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJune 18, 2020
Last NPPES UpdateOctober 23, 20242 updates tracked since enumeration
NPPES CertifiedOctober 23, 2024
✔ NPI 1902422603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TX · 1017571
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
5800 KELL BLVD STE 500, Wichita Falls, TX 76310
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shane David Statham is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527476274
PECOS Enrollment IDI20210416001248
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
259 services205 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
88 services12 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
17 services17 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
16 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

United Regional Health Care System

Acute Care Hospitals · Wichita Falls, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450010
Location1600 11th StreetWichita Falls, TX 76301 · Wichita County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76310 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

66.74/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality65.18
Promoting Interoperability82
Improvement Activities40
Cost38.95

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NORTH TEXAS ARTHRITIS & RHEUMATOLOGY PLLC
Internal Medicine (Rheumatology)
5800 KELL BLVD STE 500
WICHITA FALLS, TX 76310
Wichita County (940) 260-8550
DR. VANYA DAVID WAGLER D.O.
Internal Medicine (Rheumatology)
5800 KELL BLVD STE 500
WICHITA FALLS, TX 76310
Wichita County (940) 260-8550

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Statham's NPI number?

The NPI number for Shane Statham is 1902422603. It was assigned to this individual provider in the NPPES registry on June 18, 2020.

Where is Shane Statham located?

Shane Statham practices at 5800 Kell Blvd Ste 500, Wichita Falls, TX 76310. The listed phone number is (940) 260-8976.

What is Shane Statham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shane Statham enrolled in Medicare?

Yes. Shane Statham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shane Statham accept?

Health plans from Blue Cross and Blue Shield of Texas list Shane Statham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Shane Statham affiliated with any hospitals?

According to CMS data, Shane Statham is affiliated with United Regional Health Care System.

When was this NPI record last updated?

The NPPES record for Shane Statham was last updated on October 23, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.