Whalio Doctors

NPI 1063807022

Kristopher Ryan Shannon, MD

Practitioner Emergency Medicine Physician Pocatello, ID

Practice location

Address
850 Yellowstone Ave, Pocatello, ID 83201-4415
Phone
(208) 239-8065
Mailing address
98 Poplar St, Blackfoot, ID 83221-1799

Registered specialties (4)

Emergency Medicine Physician Primary
Allopathic & Osteopathic Physicians Taxonomy 207P00000X Licence M-16351 (ID)
Emergency Medicine Physician
Allopathic & Osteopathic Physicians Taxonomy 207P00000X Licence 12009729-1205 (UT)
Emergency Medicine Physician
Allopathic & Osteopathic Physicians Taxonomy 207P00000X Licence 17765 (NV)
Urgent Care Clinic/Center
Ambulatory Health Care Facilities Taxonomy 261QU0200X Licence M-16351 (ID)

Registry record

NPI
1063807022
Entity type
Individual
Sex (as registered)
Male
NPI issued
6 Apr 2015
Record last updated
17 Oct 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.