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

SHANNEL ANYAE PEGRAM DO
NPI 1710248653
Family Medicine in Jbsa Lackland, TX

Active since June 07, 2012PECOS Enrolled
1100 WILFORD HALL LOOP # 4554, JBSA LACKLAND, TX 78236(210) 292-6255(210) 292-7934 Get Directions Write a Review

NPPES record last updated: July 27, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shannel Anyae Pegram Do NPPES

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

SHANNEL ANYAE PEGRAM DO (NPI 1710248653) is an individual family medicine provider in Jbsa Lackland, Texas, licensed in North Carolina (183218) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710248653
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSHANNEL ANYAE PEGRAMCredential: DO
Location Address1100 WILFORD HALL LOOP # 4554Jbsa Lackland, TX 78236-5638
Mailing Address1100 Wilford Hall Loop # 4554Jbsa Lackland, TX 78236-5638 · (210) 292-6255 · Fax (210) 292-7934
Phone(210) 292-6255
Fax(210) 292-7934
Sole ProprietorYes
Enumeration DateJune 7, 2012
Last NPPES UpdateJuly 27, 2026
NPPES CertifiedJuly 27, 2026
✔ NPI 1710248653 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NC · 183218
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.
Also ListedPreventive Medicine · Occupational MedicineTaxonomy 2083X0100X · License 183218 (NC)
1100 WILFORD HALL LOOP # 4554, Jbsa Lackland, TX 78236
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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, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannel Anyae Pegram Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 78236 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

Other Providers at the Same Location NPPES 4

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

DR. JAMES MORGAN SCOTT III M.D.
Family Medicine
1100 WILFORD HALL LOOP # 4554
JBSA LACKLAND, TX 78236
Bexar County (210) 292-6259
STEVEN SIEMIENIAK DO
Emergency Medicine
1100 WILFORD HALL LOOP # 4554
JBSA LACKLAND, TX 78236
Bexar County (210) 292-7412
MARY EZINNE EZEBUIRO
Nurse Practitioner (Family)
1100 WILFORD HALL LOOP # 4554
JBSA LACKLAND, TX 78236
Bexar County (210) 292-7026
DR. RENE SAENZ D.D.S.
Dentist (General Practice)
1100 WILFORD HALL LOOP # 4554
JBSA LACKLAND, TX 78236
Bexar County (210) 292-0259

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 Shannel Pegram's NPI number?

The NPI number for Shannel Pegram is 1710248653. It was assigned to this individual provider in the NPPES registry on June 7, 2012.

Where is Shannel Pegram located?

Shannel Pegram practices at 1100 Wilford Hall Loop # 4554, Jbsa Lackland, TX 78236. The listed phone number is (210) 292-6255.

What is Shannel Pegram's specialty?

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

Is Shannel Pegram enrolled in Medicare?

Yes. Shannel Pegram is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shannel Pegram was last updated on July 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 days 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.