Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Miss. Courtney Nicole Shaffer, PA-C

Individual provider Surgical Physician Assistant · NPI 1093209041

Miss. Courtney Nicole Shaffer, PA-C is a Physician Assistant in Kokomo, Indiana. Qualified in 2018, 8 years ago. Practices with St Vincent Medical Group Inc, a 727-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
8
Licensed in
IN
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

1907 W Sycamore St # 200
Kokomo, IN 46901-5148
Phone: (765) 236-8170
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2485 E Wabash St, Frankfort, IN 46041-9400 — (765) 236-8170
  • 1101 Michigan Ave, Logansport, IN 46947 — (574) 753-7541

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 10002483A (IN)

Record details

NPI number1093209041
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 21, 2018
Last updated in NPPESAugust 9, 2024
Certification dateAugust 9, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice St Vincent Medical Group Inc — 727 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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