Shannan C. Vincent, PT
NPI 1982249090ActiveIndividual· Physical Therapist· South Bend, IN
Physical Therapist (PT) with Senior Outpatient Services, practicing in South Bend, Indiana. Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1982249090 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT |
| Sole proprietor | Yes |
| NPI issued | Nov 12, 2019 |
| Last updated in NPPES | Jun 30, 2026 |
| Certified by provider | Jun 30, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 05003605A | IN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (IN) |
|---|
Education and affiliations
| Graduation year | 1993 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Senior Outpatient ServicesElkhart, IN · 11 clinicians
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