Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KRISTOPHER RYAN SHANNON, M.D.
Active Sole ProprietorDR. KRISTOPHER RYAN SHANNON, M.D. is a Emergency Medicine healthcare provider located in POCATELLO, Idaho. NPI 1063807022 is currently active in the NPPES registry. Verify at CMS.
Emergency Medicine · POCATELLO, ID
Registration Details
- NPI Number
- 1063807022
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 6, 2015 (11.381467902156 yrs)
- Last Updated
- Oct 17, 2025
- Licenses
-
M-16351 (ID)12009729-1205 (UT)17765 (NV)M-16351 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
850 YELLOWSTONE AVEPOCATELLO, ID, 832014415Browse ID providers · Browse ZIP 83201
- Phone
- 2082398065
- Primary Specialty
-
Emergency Medicine
207P00000X
- Additional Specialty
- Emergency Medicine
- Additional Specialty
- Emergency Medicine
- Additional Specialty
- Urgent Care Center
Other Emergency Medicine Providers in POCATELLO, ID
| Name | Credential | NPI |
|---|---|---|
| CRAIG BOSLEY | MD | 1992740120 |
| WILLIS PARMLEY | MD | 1659316974 |
| DOUGLAS FAVOR | MD | 1619912953 |
| KENNETH RYAN | MD | 1003843343 |
| JAMES SHAW | MD | 1942238183 |
| ANDREW BRADBURY | MD | 1720016967 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.