SHANNON JENKINS DO NPI 1023083680

NPI Information

NPI: 1023083680
Provider Name: SHANNON JENKINS, DO
Classification: Pediatrics - 2080N0001X
Entity Type: Individual

Specialization: Neonatal-Perinatal Medicine

Address:
2860 CHANNING WAY
SUITE 100
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 535-4575
Get Directions

Shannon Jenkins, DO is a neonatal-perinatal medicine pediatrics in Idaho Falls, ID. The provider is a pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. Shannon Jenkins, DO NPI is 1023083680. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2860 CHANNING WAY
SUITE 100
IDAHO FALLS, ID
ZIP 83404-531
Phone: (208) 535-4575
Fax: (208) 535-4569

The enumeration date for this NPI number is 2/17/2006 and was last updated on 12/23/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080N0001X	Pediatrics	Neonatal-Perinatal Medicine	3863	ARIZONA	No
2	2080N0001X	Pediatrics	Neonatal-Perinatal Medicine	O0424	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	0117377	MEDICAID	MONTANA
2	121542600	MEDICAID	IDAHO
3	H80981	MEDICARE UPIN	IDAHO
4	121542600	MEDICAID	WYOMING
5	H80981	MEDICARE UPIN	ARIZONA
6	1285786046	MEDICAID	WYOMING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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