SHANNON CLINIC
NPI 1790986719
Pediatrics in Del Rio, TX
About Shannon Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHANNON CLINIC (NPI 1790986719), doing business as Vista Verde Medical Plaza, is a healthcare organization registered as a pediatrics in Del Rio, Texas and active in the NPI registry since May 2007. The organization lists Gary Bowen, Chief Operations Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shannon Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
662Medicare enrollment records show 662 clinicians reassign Medicare billing to Shannon Clinic, which bills Medicare for the services they deliver. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 51
Nearest to this location (20)
See all 662Source: 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 Shannon Clinic's NPI number?
The NPI number for Shannon Clinic is 1790986719. It was assigned to this organization in the NPPES registry on May 29, 2007. The provider is doing business as Vista Verde Medical Plaza.
Where is Shannon Clinic located?
Shannon Clinic is located at 1801 N Bedell Ave, Del Rio, TX 78840. The listed phone number is (830) 768-9200.
What is Shannon Clinic's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Shannon Clinic enrolled in Medicare?
Yes. Shannon Clinic is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Shannon Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 662 clinicians in 51 Medicare specialties reassign their Medicare billing to Shannon Clinic. 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. The largest specialties are Nurse Practitioner (121), Diagnostic Radiology (76) and Internal Medicine (55). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Shannon Clinic accept?
Health plans from Blue Cross and Blue Shield of Texas list Shannon Clinic 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.
When was this NPI record last updated?
The NPPES record for Shannon Clinic was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Shannon Clinic · NPI 1790986719
Pediatrics organization in Del Rio, Texas. Organization record, active in the CMS NPPES registry since May 29, 2007.
## Identity
- **NPI:** 1790986719 (Entity type: Organization)
- **Enumerated:** May 29, 2007
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **Also known as:** VISTA VERDE MEDICAL PLAZA (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Gary Bowen, CHIEF OPERATIONS OFFICER
## Practice location
- **Address:** 1801 N BEDELL AVE, Del Rio, TX 78840-8001
- **Phone:** (830) 768-9200
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 662 clinicians in 51 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (121), Diagnostic Radiology (76), Internal Medicine (55); [full list](https://npiprofile.com/npi/1790986719/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 11, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1790986719) · Data from the CMS NPPES public registry.