JOSEPH SHANNON (DPT) – Physical Therapist, NPI 1083134688

JOSEPH SHANNON (DPT) is a healthcare provider. based in Clackamas, Oregon. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 62366 (OR). The NPI Number for JOSEPH SHANNON (DPT) is 1083134688

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
JOSEPH SHANNON (DPT)
NPI
1083134688
Phone
(503) 794-0103
Address
10121 SE Sunnyside Rd Ste 208
Enumeration Date
23 June 2017
Last Update Date
17 March 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5039906393
Graduation Year
2017 (9 years ago)
PAC ID
5597003608
Group Practice PAC ID
7517115579
Professional Enrollment ID
I20190215000960
Address ID
OR973021172SA3871XSEXX501
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

1,808 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OR

Provider Addresses for JOSEPH SHANNON (DPT)

  • 10121 SE Sunnyside Rd Ste 208

    Clackamas, OR 970155750

    Phone: (503) 794-0103

    Type: Location

  • Southeast Sunnyside Road, Happy Valley, Metro, Clackamas County, Oregon, 97015, United States

    CLACKAMAS, OR 970155750

    Phone: (503) 794-0103

    Type: Mailing

  • Northwest Cornell Road, Beaverton, Metro, Washington County, Oregon, 97229-5688, United States

    BEAVERTON, OR 970065627

    Phone: (971) 245-6663

    Fax: (971) 245-6664

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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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: 2019-02-15

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190215000960IPhysical Therapist In Private PracticeORTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes28822$0
97530Therapy procedure using functional activities19216$0
97161Evaluation for physical therapy, typically 20 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 97015)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7517115579View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeOR
Occupational Therapist In Private PracticeNV
Physical Therapist In Private PracticeOR
Occupational Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeOR
Occupational Therapist In Private PracticeAZ
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR
Physical Therapist In Private PracticeOR

Reviews

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Frequently asked questions

Where can patients find JOSEPH SHANNON (DPT)'s NPI?
You can confirm JOSEPH SHANNON (DPT) with NPI 1083134688; it appears in the national provider directory.
Is JOSEPH SHANNON (DPT) currently active in the NPI registry?
CMS-published data lists JOSEPH SHANNON (DPT) as an active registrant.
What kind of provider is JOSEPH SHANNON (DPT)?
The page reflects Physical Therapist for JOSEPH SHANNON (DPT). Clinical services aligned with this taxonomy classification.
Where does public data place JOSEPH SHANNON (DPT)?
The snapshot lists Clackamas, Oregon for JOSEPH SHANNON (DPT); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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