Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

COURTNEY HOLDEN SHOEMAKER PA
NPI 1386329308
Physician Assistant in South Bend, IN

Q: What is Courtney Shoemaker's NPI number?

The NPI number for Courtney Shoemaker is 1386329308. It was assigned to this individual provider in the NPPES registry on June 19, 2023. The provider is also known as Courtney Michelle Holden Rdcs.

Q: What is Courtney Shoemaker's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since June 19, 2023PECOS Enrolled

610 N MICHIGAN ST STE 400, SOUTH BEND, IN 46601(574) 647-8120(574) 647-8111 Get Directions Write a Review

NPPES record last updated: October 2, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 2, 2026, Jun 19, 2023 (2 updates tracked since 2023).

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About Courtney Holden Shoemaker Pa NPPES

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

COURTNEY HOLDEN SHOEMAKER PA (NPI 1386329308) is an individual physician assistant in South Bend, Indiana, licensed in Indiana (10005400A) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2026).

NPPES Registry Identity

NPI1386329308

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameCOURTNEY HOLDEN SHOEMAKERCredential: PA

Location Address610 N MICHIGAN ST STE 400South Bend, IN 46601-1081

Mailing Address3245 Health Dr Ste 100Granger, IN 46530-1380 · (574) 647-2713

Phone(574) 647-8120

Fax(574) 647-8111

Sole ProprietorNo

Medical School CMSOtherGraduated 2026

Enumeration DateJune 19, 2023

Last NPPES UpdateOctober 2, 20262 updates tracked since enumeration

NPPES CertifiedOctober 2, 2026

✔ NPI 1386329308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in IN · 10005400A

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

610 N MICHIGAN ST STE 400, South Bend, IN 46601

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Other Names 1

Former Name (1)Courtney Michelle Holden Rdcs

Secondary Practice Locations 3

Location 13220 Beacon Pkwy Ste 200Granger, IN 46530-7196 · Phone (574) 647-8788 · Fax (574) 647-3321

Location 21020 High RdBremen, IN 46506-1093 · Phone (574) 309-9967 · Fax (574) 309-9968

Location 3610 N Michigan St Ste 306South Bend, IN 46601-1079 · Phone (574) 647-6500 · Fax (574) 647-6518

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Courtney Holden Shoemaker Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6204397771

PECOS Enrollment IDI20260915001165

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46601 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

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$66.48 typical visit price

range $16.93 – $132.22

Typical copayment $16.62 (range $4.23 – $33.05)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

MAYANK KUMAR MITTAL MD

Internal Medicine (Interventional Cardiology)