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DR. KRISTOPHER RYAN SHANNON M.D.
NPI 1063807022
Emergency Medicine in Pocatello, ID

Active since April 06, 2015PECOS EnrolledAccepts Medicare Assignment
850 YELLOWSTONE AVE, POCATELLO, ID 83201(208) 239-8065 Get Directions Write a Review

NPPES record last updated: October 17, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 22, 2024, Jun 8, 2022, Jun 28, 2018 (3 updates tracked since 2018).

About Dr. Kristopher Ryan Shannon M.d. NPPES

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

DR. KRISTOPHER RYAN SHANNON M.D. (NPI 1063807022) is an individual emergency medicine provider in Pocatello, Idaho, licensed in Idaho (M-16351) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Portneuf Medical Center, and maintains a secondary practice location in Blackfoot.

NPPES Registry Identity

NPI1063807022
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. KRISTOPHER RYAN SHANNONCredential: M.D.
Location Address850 YELLOWSTONE AVEPocatello, ID 83201-4415
Mailing Address98 Poplar StBlackfoot, ID 83221-1799 · (208) 785-3813
Phone(208) 239-8065
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateApril 6, 2015
Last NPPES UpdateOctober 17, 20253 updates tracked since enumeration
NPPES CertifiedOctober 17, 2025
✔ NPI 1063807022 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Licenses✔ Licensed in ID · M-16351✔ Licensed in UT · 12009729-1205✔ Licensed in NV · 17765
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedClinic/Center · Urgent CareTaxonomy 261QU0200X · License M-16351 (ID)
850 YELLOWSTONE AVE, Pocatello, ID 83201
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Secondary Practice Location 1

Location 198 Poplar StBlackfoot, ID 83221-1799 · Phone (208) 785-3813

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kristopher Ryan Shannon M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1153637384
PECOS Enrollment IDI20180525002124, I20220225001754
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Kristopher Shannon reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Bmh, Inc.
Same address
Family Medicine
850 YELLOWSTONE AVE STE B
Pocatello, ID 83201
  • Reassigned Medicare billing, Idaho enrollment
  • Also billed through NPI 1982805271 (Idaho)
  • 159 clinicians in this Medicare group
NPI 1215511241 (208) 239-8066
Rocky Mountain Physician Group LLC
2.1 mi
Emergency Medicine
777 HOSPITAL WAY
Pocatello, ID 83201
  • Reassigned Medicare billing, Idaho enrollment
  • 16 clinicians in this Medicare group
NPI 1851808133 (480) 421-9700
Fremont Emergency Services Scherr Ltd
478 mi
Emergency Medicine
7207 ALIANTE PARKWAY
North Las Vegas, NV 89128
  • Reassigned Medicare billing, Nevada enrollment
  • 304 clinicians in this Medicare group
NPI 1316488141 (702) 962-5000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Portneuf Medical Center

Acute Care Hospitals · Pocatello, ID
4/5 CMS rating
OwnershipProprietary
CMS Certification Number130028
Location777 Hospital WayPocatello, ID 83201 · Bannock County
Emergency services Birthing friendly

Bingham Memorial Hospital

Critical Access Hospitals · Blackfoot, ID
OwnershipVoluntary non-profit - Private
CMS Certification Number131325
Location98 Poplar StreetBlackfoot, ID 83221 · Bingham County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83201 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
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$93.26 typical visit price
range $16.68 – $130.93
Typical copayment $23.31 (range $4.17 – $32.73)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers12 claims12 services$19.38 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers12 claims12 services$103.44 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

DR. RYAN DON HOPE M.D.
Anesthesiology (Addiction Medicine)
850 YELLOWSTONE AVE
POCATELLO, ID 83201
Bannock County (208) 239-8066

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kristopher Shannon's NPI number?

The NPI number for Kristopher Shannon is 1063807022. It was assigned to this individual provider in the NPPES registry on April 6, 2015.

Where is Kristopher Shannon located?

Kristopher Shannon practices at 850 Yellowstone Ave, Pocatello, ID 83201. The listed phone number is (208) 239-8065.

What is Kristopher Shannon's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Kristopher Shannon enrolled in Medicare?

Yes. Kristopher Shannon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kristopher Shannon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kristopher Shannon reassigns Medicare benefits to 3 organizations: Bmh, Inc. (Pocatello, ID), Rocky Mountain Physician Group LLC (Pocatello, ID) and Fremont Emergency Services Scherr Ltd (North Las Vegas, NV). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kristopher Shannon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kristopher Shannon accept?

Health plans from Moda Health Plan, Inc. list Kristopher Shannon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kristopher Shannon affiliated with any hospitals?

According to CMS data, Kristopher Shannon is affiliated with Portneuf Medical Center and Bingham Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Kristopher Shannon was last updated on October 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.