MICHAEL DAVID SHANNON (DPT, CSCS) – Physical Therapist, NPI 1083599062

MICHAEL DAVID SHANNON (DPT, CSCS) is a healthcare provider. based in Shippensburg, Pennsylvania. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT, CSCS. They hold a License No. PT033629 (PA). The NPI Number for MICHAEL DAVID SHANNON (DPT, CSCS) is 1083599062

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
MICHAEL DAVID SHANNON (DPT, CSCS)
NPI
1083599062
Phone
(717) 477-8030
Address
20 PARK PL STE 2
Enumeration Date
8 August 2025
Last Update Date
8 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7178273186
Graduation Year
2025 (1 year ago)
PAC ID
7214438340
Group Practice PAC ID
2860598364
Professional Enrollment ID
I20250829003608
Address ID
PA173251528GE371XXSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

4,258 PHYSICAL THERAPIST IN PRIVATE PRACTICE in PA

Provider Addresses for MICHAEL DAVID SHANNON (DPT, CSCS)

  • 20 PARK PL STE 2

    SHIPPENSBURG, PA 172579806

    Phone: (717) 477-8030

    Fax: (717) 477-8030

    Type: Mailing

  • 371 E WATER ST STE 1

    GETTYSBURG, PA 173251503

    Phone: (717) 549-2945

    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: 2025-08-29

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
I20250829003608IPhysical Therapist In Private PracticePATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 17257)

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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: 2860598364View full group profile
NameSpecialtyState
-PA
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeNC
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA

Reviews

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Frequently asked questions

What is the 10-digit NPI for MICHAEL DAVID SHANNON (DPT, CSCS)?
MICHAEL DAVID SHANNON (DPT, CSCS) — NPI 1083599062 — is the standard way to identify this listing.
Can I rely on MICHAEL DAVID SHANNON (DPT, CSCS) being an active provider?
As of the registry snapshot, MICHAEL DAVID SHANNON (DPT, CSCS) is marked active.
What healthcare role does MICHAEL DAVID SHANNON (DPT, CSCS) hold?
Scheduling teams often label MICHAEL DAVID SHANNON (DPT, CSCS) under Physical Therapist. Clinical services aligned with this taxonomy classification.
Where should I expect MICHAEL DAVID SHANNON (DPT, CSCS) on a map?
Expect Shippensburg, Pennsylvania as a primary anchor for MICHAEL DAVID SHANNON (DPT, CSCS) unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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