Kristopher Shannon, M.D.
Kristopher Shannon, M.D. is an Emergency Medicine Physician in Pocatello, ID, registered under NPI 1063807022. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 850 YELLOWSTONE AVE, Pocatello, ID 83201. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| M-16351 | ID | Emergency Medicine Physician primary |
| 12009729-1205 | UT | Emergency Medicine Physician |
| 17765 | NV | Emergency Medicine Physician |
| M-16351 | ID | Urgent Care Clinic/Center |
Licences are recorded in 3 states: ID, UT, NV. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Emergency Medicine
- PAC ID
- 1153637384
Medicare enrolment is recorded as approved under the provider type Practitioner - Emergency Medicine. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 3 states
This provider holds licences in 3 states: Idaho, Nevada and Utah. The practice address on file is in Pocatello, ID, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- M-16351
- Specialty
- Emergency Medicine Physician
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Emergency Medicine covers
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 response to acute illness and injury. NUCC Health Care Provider Taxonomy, code 207P00000X
All registered taxonomy codes
This provider registers 4 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine Physician | M-16351 | ID | primary |
| 207P00000X | Emergency Medicine Physician | 12009729-1205 | UT | |
| 207P00000X | Emergency Medicine Physician | 17765 | NV | |
| 261QU0200X | Urgent Care Clinic/Center Urgent Care | M-16351 | ID |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1063807022 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Apr 6, 2015 |
| Last updated | Oct 17, 2025 |
| Status | Active |
| Sole proprietor | Yes |
| Credential | M.D. |
| Practice address |
850 YELLOWSTONE AVE Pocatello, ID 83201 (208) 239-8065 |
| Mailing address |
98 POPLAR ST Blackfoot, ID 83221 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 6 | 3 | 8 | 0 | 7 | 0 | 2 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 3 | 3 | 7 | 0 | 5 | 0 | 4 |
Sum = 48 · next multiple of 10 = 50 · check digit = 2 · actual last digit = 2
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.