DOMINIK ALAN SHANNON (PT, DPT) – Physical Therapist, NPI 1114409273

DOMINIK ALAN SHANNON (PT, DPT) is a healthcare provider. based in Chattanooga, Tennessee. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. PT013656 (GA). The NPI Number for DOMINIK ALAN SHANNON (PT, DPT) is 1114409273

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
DOMINIK ALAN SHANNON (PT, DPT)
NPI
1114409273
Phone
(423) 238-7217
Address
6397 LEE HWY STE 300
Enumeration Date
5 September 2018
Last Update Date
5 September 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6784509933
Graduation Year
2018 (8 years ago)
PAC ID
8628321882
Group Practice PAC ID
5890692917
Professional Enrollment ID
I20181105003621
Address ID
GA305195107BU2800XDRXX308
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

2,871 PHYSICAL THERAPIST IN PRIVATE PRACTICE in GA

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Provider Addresses for DOMINIK ALAN SHANNON (PT, DPT)

  • 6397 LEE HWY STE 300

    CHATTANOOGA, TN 374212564

    Phone: (423) 238-7217

    Fax: (423) 362-8684

    Type: Mailing

  • Intown Hardware, 842, North Highland Avenue Northeast, Virginia Highland, Atlanta, Fulton County, Georgia, 30306, United States

    ATLANTA, GA 303064530

    Phone: (678) 685-9356

    Fax: (678) 685-9357

    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: 2018-11-05

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
I20181105003621IPhysical Therapist In Private PracticeGATBD

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 minutes17824$0
97530Therapy procedure using functional activities10818$0
97140Therapy procedure using manual technique, each 15 minutes9425$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes8917$0
View full utilization report →

Insurance plans in this area (ZIP 37421)

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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: 5890692917View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeTN
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeTN
-GA
-GA

Reviews

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Frequently asked questions

What is the 10-digit NPI for DOMINIK ALAN SHANNON (PT, DPT)?
DOMINIK ALAN SHANNON (PT, DPT) — NPI 1114409273 — is the standard way to identify this listing.
Does CMS list DOMINIK ALAN SHANNON (PT, DPT) as active?
Yes — DOMINIK ALAN SHANNON (PT, DPT) is active in the NPI listing used on this page.
What healthcare role does DOMINIK ALAN SHANNON (PT, DPT) hold?
Scheduling teams often label DOMINIK ALAN SHANNON (PT, DPT) under Physical Therapist. Clinical services aligned with this taxonomy classification.
Where should I expect DOMINIK ALAN SHANNON (PT, DPT) on a map?
Expect Chattanooga, Tennessee as a primary anchor for DOMINIK ALAN SHANNON (PT, DPT) unless the record lists multiple sites.
Why does DOMINIK ALAN SHANNON (PT, DPT) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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