Search › Idaho › 207P00000X
Kristopher Shannon, M.D
NPI 1063807022 · on the registry since 2015 · sole proprietor
Practice
- Address
- 850 Yellowstone Ave
Pocatello, ID 83201 - Phone
- (208) 239-8065
- Organisation at this address
- Bmh, Inc.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Additional practice sites
- 98 Poplar St, Blackfoot, ID
Registry record
- Primary taxonomy
- 207P00000X
207P00000X
- Also registered as
- 207P00000X
207P00000X
261QU0200X - Licence states on file
- ID, UT, NV
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-10-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho