DR SHANNA R NEWBOLD M D INC
NPI 1104541572
Emergency Medicine in Banning, CA

Q: What is Dr Shanna R Newbold M D Inc's NPI number?

The NPI number for Dr Shanna R Newbold M D Inc is 1104541572. It was assigned to this organization in the NPPES registry on October 7, 2022. The provider is doing business as San Gorgonio Wound Care.

Q: What is Dr Shanna R Newbold M D Inc's specialty?

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

Active since October 07, 2022

264 N HIGHLAND SPRINGS AVE STE A, BANNING, CA 92220(951) 381-2122(951) 561-7155 Get Directions Write a Review

NPPES record last updated: March 10, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 10, 2026, Mar 13, 2025, Jan 12, 2023 and 2 more (5 updates tracked since 2022).

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About Dr Shanna R Newbold M D Inc NPPES

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

DR SHANNA R NEWBOLD M D INC (NPI 1104541572), doing business as San Gorgonio Wound Care, is a healthcare organization registered as an emergency medicine in Banning, California and active in the NPI registry since October 2022. The organization lists Shanna Newbold, Owner, as its authorized official.

NPPES Registry Identity

NPI1104541572

Entity TypeOrganization

Primary Taxonomy207P00000X

Legal Business NameDR SHANNA R NEWBOLD M D INC

Location Address264 N HIGHLAND SPRINGS AVE STE ABanning, CA 92220-3082

Mailing Address264 N Highland Springs Ave Ste ABanning, CA 92220-3082

Phone(951) 381-2122

Fax(951) 561-7155

Organization SubpartNo

Authorized OfficialShanna NewboldOwner · (951) 381-2122

Enumeration DateOctober 7, 2022

Last NPPES UpdateMarch 10, 20265 updates tracked since enumeration

NPPES CertifiedMarch 10, 2026

✔ NPI 1104541572 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

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.

264 N HIGHLAND SPRINGS AVE STE A, Banning, CA 92220

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Other Names 1

Doing Business AsSan Gorgonio Wound Care

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr Shanna R Newbold M D Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Dr Shanna R Newbold M D Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Shanna Newbold, M.D.

General Practice

NPI 1932407632

264 N HIGHLAND SPRINGS AVE STE A
Banning, CA 92220

(661) 326-2000

✔ PECOS✔ Accepts MedicareSame address

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

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 Dr Shanna R Newbold M D Inc's NPI number?

The NPI number for Dr Shanna R Newbold M D Inc is 1104541572. It was assigned to this organization in the NPPES registry on October 7, 2022. The provider is doing business as San Gorgonio Wound Care.

Where is Dr Shanna R Newbold M D Inc located?

Dr Shanna R Newbold M D Inc is located at 264 N Highland Springs Ave Ste A, Banning, CA 92220. The listed phone number is (951) 381-2122.

What is Dr Shanna R Newbold M D Inc's specialty?

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

Is Dr Shanna R Newbold M D Inc enrolled in Medicare?

Yes. Dr Shanna R Newbold M D Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dr Shanna R Newbold M D Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (General Practice) reassigns their Medicare billing to Dr Shanna R Newbold M D Inc. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Dr Shanna R Newbold M D Inc was last updated on March 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.