Individual provider · Type 1 NPI

Kristopher Ryan Shannon, MD

Emergency Medicine Physician · Pocatello, ID

NPI number 1063807022 Active

Practice location

850 Yellowstone Ave
Pocatello, ID 83201-4415

Call (208) 239-8065 Map

Mailing address

98 Poplar St
Blackfoot, ID 83221-1799

Other practice locations

  • 98 Poplar St, Blackfoot, ID 83221-1799 · (208) 785-3813

Specialties and licenses

TaxonomyCodeLicense
Emergency Medicine Physician Primary 207P00000XM-16351 (ID)
Emergency Medicine Physician 207P00000X12009729-1205 (UT)
Emergency Medicine Physician 207P00000X17765 (NV)
Urgent Care Clinic/Center 261QU0200XM-16351 (ID)

Emergency Medicine Physician: 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 respo…

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About NPI 1063807022

Kristopher Ryan Shannon, MD's National Provider Identifier is 1063807022, issued on Apr 6, 2015. The primary taxonomy on file is Emergency Medicine Physician (207P00000X), and the practice location is in Pocatello, ID. The record was last updated on Oct 17, 2025.