DR. KEVIN CHARLES SHANNON M.D.
NPI 1356470314
Family Medicine in San Bernardino, CA

Q: What is Kevin Shannon's NPI number?

The NPI number for Kevin Shannon is 1356470314. It was assigned to this individual provider in the NPPES registry on March 5, 2007.

Q: What is Kevin Shannon's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Shannon was last updated on January 9, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 05, 2007PECOS EnrolledAccepts Medicare Assignment

1454 E 2ND ST, SAN BERNARDINO, CA 92408(909) 382-7146(909) 382-7101 Get Directions Write a Review

NPPES record last updated: January 9, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Dr. Kevin Charles Shannon M.d. NPPES

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

DR. KEVIN CHARLES SHANNON M.D. (NPI 1356470314) is an individual family medicine provider in San Bernardino, California, licensed in California (G89186) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (1985).

NPPES Registry Identity

NPI1356470314

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. KEVIN CHARLES SHANNONCredential: M.D.

Location Address1454 E 2ND STSan Bernardino, CA 92408-0118

Mailing Address1454 E 2nd StSan Bernardino, CA 92408-0118 · (909) 382-7146 · Fax (909) 382-7101

Phone(909) 382-7146

Fax(909) 382-7101

Sole ProprietorNo

Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1985

Enumeration DateMarch 5, 2007

Last NPPES UpdateJanuary 9, 2026

NPPES CertifiedJanuary 9, 2026

✔ NPI 1356470314 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in CA · G89186

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1454 E 2ND ST, San Bernardino, CA 92408

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Other Identifiers 2

Medicaid30201226NH

Medicaid0RE6020VT

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kevin Charles 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 ID3072544782

PECOS Enrollment IDI20120821000322

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 92408 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

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

Established Patient

$104.64 typical visit price

range $19.37 – $146.42

Typical copayment $26.16 (range $4.84 – $36.60)

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 3

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

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034

Other-Enteral and Parenteral · category OB006N

1 supplier13 claims390 services$2.43 avg. paid by Medicare

Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4150

Other-Enteral and Parenteral · category OB006N

1 supplier13 claims4,550 services$0.29 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$23.19 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 20

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

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