Shannon Jenkins, DO

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

O0424 Issued in ID

Practice address

2860 Channing Way
Suite 100
Idaho Falls, ID 83404-7531

Phone

(208) 535-4575

Fax

(208) 535-4569

NPI assigned

Feb 17, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in ID, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Pediatric Medicine

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sjenkins4619882@direct.trinity-health.org
• Direct secure messaging: sjenkins262011@ahs.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Saint Alphonsus Regional Medical Center Inc

  • Psychologist
  • Boise, ID
  • NPI 1649357716

  ID

  Medicare reassignment NPD
• Norton Children'S Medical Group, LLC

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1457999096

  KY

  Medicare reassignment
• Saint Alphonsus Regional Medical Center Inc

  • Psychiatric Hospital Unit
  • Boise, ID
  • NPI 1770687857
  NPD
• Saint Alphonsus Regional Medical Center Inc

  • Family Medicine Physician
  • Caldwell, ID
  • NPI 1861676298

  Family Medicine

  NPD
• Norton Children'S Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Louisville, KY
  • NPI 1134760796
  NPD
• Norton Children'S Medical Group, LLC

  • Pediatric Radiology Physician
  • Louisville, KY
  • NPI 1659913812
  NPD
• Mountain States Neonatology, Inc.

  • Neonatal-Perinatal Medicine Physician
  • Boise, ID
  • NPI 1205850823

  Neonatal-Perinatal Medicine

  NPD (past)
• Northwest Hospital LLC

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1477636108

  Family Medicine

  NPD (past)
• Norton Childrens Medical Group, LLC

  • Pediatrics Physician
  • Louisville, KY
  • NPI 1326695255

  Neonatal-Perinatal Medicine

  NPD (past)
• Pediatrix Medical Group, Inc.

  • Neonatal-Perinatal Medicine Physician
  • Sunrise, FL
  • NPI 1730265919

  Neonatal-Perinatal Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1023083680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 CHANNING WAY STE 100",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047531",
            "telephone_number": "208-535-4575",
            "fax_number": "208-535-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 CHANNING WAY",
            "address_2": "SUITE 100",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047531",
            "telephone_number": "208-535-4575",
            "fax_number": "208-535-4569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 E Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021713",
            "country_code": "US",
            "telephone_number": "502-588-0982",
            "fax_number": "502-588-0987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "SHANNON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "ID",
            "license": "O0424",
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "AZ",
            "license": "3863",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "KY",
            "license": "C4692",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0117377",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121542600",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121542600",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285786046",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Jenkins, PA-C
• Bridget Jenkins
• Darrell L Jenkins, CRNA
• Jenny Ellen Jenkins, BS, TCC/CM
• M'Kenzi Ann Jenkins, LMT
• Tracy Dean Jenkins, D.D.S.
• Desiree Jenks-Asay, LPC
• Abby Lucile Jensen
• Alan Jensen
• Alan Joel Jensen, PA

• All providers in Idaho Falls, ID
• Neonatal-Perinatal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.