Dr Kristopher Ryan Shannon, MD in Pocatello, ID

Dr Kristopher Ryan Shannon, MD is a medicare enrolled "Emergency Medicine" physician in Pocatello, Idaho. He graduated from medical school in 2015 and has 11 years of diverse experience with area of expertise as Emergency Medicine. He is a member of the group practice Fremont Emergency Services Scherr Ltd, Bmh Inc and his current practice location is 850 Yellowstone Ave, Pocatello, Idaho. You can reach out to his office (for appointments etc.) via phone at (208) 239-8065.

Dr Kristopher Ryan Shannon is licensed to practice in Idaho (license number M-16351) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1063807022.

Contact Information

	Dr Kristopher Ryan Shannon, MD
	850 Yellowstone Ave, Pocatello, ID 83201-4415
	(208) 239-8065
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Kristopher Ryan Shannon
Gender	Male
Speciality	Emergency Medicine
Experience	11 Years
Location	850 Yellowstone Ave, Pocatello, Idaho
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Kristopher Ryan Shannon graduated from medical school in 2015

NPI Data:

NPI Number: 1063807022
Provider Enumeration Date: 04/06/2015
Last Update Date: 10/17/2025

Medicare PECOS Information:

PECOS PAC ID: 1153637384
Enrollment ID: I20180525002124

Medical Identifiers

Medical identifiers for Dr Kristopher Ryan Shannon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063807022	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	M-16351 (Idaho)	Primary
207P00000X	Emergency Medicine	12009729-1205 (Utah)	Secondary
207P00000X	Emergency Medicine	17765 (Nevada)	Secondary
261QU0200X	Clinic/center - Urgent Care	M-16351 (Idaho)	Secondary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Bingham Memorial Hospital	Blackfoot, ID	Hospital
Portneuf Medical Center	Pocatello, ID	Hospital
Mountainview Hospital	Las vegas, NV	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Fremont Emergency Services Scherr Ltd	4880684554	122
Bmh Inc	8426149758	124

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kristopher Ryan Shannon allows following entities to bill medicare on his behalf.

Entity Name	Fremont Emergency Services Scherr Ltd
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1679550149 PECOS PAC ID: 4880684554 Enrollment ID: O20040514000465

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kristopher Ryan Shannon is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Kristopher Ryan Shannon, MD 98 Poplar St, Blackfoot, ID 83221-1799 Ph: (208) 785-3813	Dr Kristopher Ryan Shannon, MD 850 Yellowstone Ave, Pocatello, ID 83201-4415 Ph: (208) 239-8065

Reviews and Comments

Emergency Medicine Doctors in Pocatello, ID

Kenneth Ryan, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 651 Memorial Dr, Pocatello, ID 83201 Phone: 208-239-1000
Randall Fowler, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 651 Memorial Dr, Pocatello, ID 83201 Phone: 208-239-1000
Dr. Jordon Marshall, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 777 Hospital Way, Emergency Department, Pocatello, ID 83201 Phone: 208-239-1801
Dr. Morgan Newel Anderson, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 777 Hospital Way, Pocatello, ID 83201 Phone: 208-239-1000
Charles O Garrison, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1125 W Alameda Rd, Pocatello, ID 83201 Phone: 208-237-1151 Fax: 208-237-9721
Dr. Andrew Lee Vincent, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 777 Hospital Way, Pocatello, ID 83201 Phone: 208-417-7569 Fax: 480-421-9899

Dr Kristopher Ryan Shannon, MD - Medicare Emergency Medicine in Pocatello, ID