Individual provider Active NPI

Roy Carl Shannon, MD

  • Internal Medicine Physician
  • Oroville, CA
National Provider Identifier
1104880335
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C35734 Issued in CA
Practice address
2721 Olive Hwy
Ste 12
Oroville, CA 95966
Phone
(530) 533-6061
Fax
(530) 533-4438
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C35734 CA Primary

Addresses

Primary practice location

2721 Olive Hwy
Ste 12
Oroville, CA 95966

Mailing address

2721 Olive Hwy
Ste 12
Oroville, CA 95966
Phone (530) 533-6061

Other identifiers 1

IdentifierTypeStateIssuer
GR0014101MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080114000330 CA Practitioner - Internal Medicine 4981512969 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35734CAMDMarriage & Family Therapist
C35734CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orohealth Corporation a Non Profit Healthcare System Internal Medicine CurrentSince Dec 1, 2007 Accepting new patients
Oroville Internal Medicine Medical Group,Inc. PastSince Jan 9, 2008 Accepting new patients

Locations

2721 Olive Hwy
Ste 12
Oroville, CA 95966
Phone (530) 533-6061

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

2721 Olive Hwy
Ste 10B
Oroville, CA 95966
Phone (530) 532-8687

2767 Olive Hwy
Ste 12
Oroville, CA 95966
Phone (530) 532-8260

2721 Olive Hwy
Ste 12A
Oroville, CA 95966
Phone (530) 532-8687

2760 Oro Dam Blvd E
Ste A
Oroville, CA 95966
Phone (530) 534-0601

2767 Olive Hwy
#260
Oroville, CA 95966
Phone (530) 532-8544

2809 Olive Hwy
Ste 220
Oroville, CA 95966
Phone (530) 532-8161

2809 Olive Hwy
Oroville, CA 95966
Phone (530) 532-8654

Ownership & related parties

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Oroville HospitalOroville, CA, CCN 050030 Hospital Corporate Director Jun 29, 2017
Oroville Hospital Post Acute CenterOroville, CA, CCN 555281 Skilled nursing facility Corporate Officer Jun 27, 2014
Oroville Hospital Annex BuildingOroville, CA, CCN 058601 Rural health clinic Corporate Director Sep 25, 2014
Premier Health CenterOroville, CA, CCN 058584 Rural health clinic Corporate Director Sep 25, 2014
Family PracticeOroville, CA, CCN 058585 Rural health clinic Corporate Officer Sep 25, 2014
Oroville Pediatric AssociatesOroville, CA, CCN 058583 Rural health clinic Corporate Director Sep 25, 2014
Family Medicine PracticeOroville, CA, CCN 058656 Rural health clinic Corporate Director Sep 25, 2014
Oroville Women'S HealthOroville, CA, CCN 058661 Rural health clinic Corporate Director Jan 1, 2016
Primary Care PracticeOroville, CA, CCN 058686 Rural health clinic Corporate Director Sep 25, 2014
Premier Health PracticeOroville, CA, CCN 058711 Rural health clinic Corporate Officer Sep 25, 2014

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104880335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 OLIVE HWY",
            "address_2": "STE 12",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "95966",
            "telephone_number": "530-533-6061",
            "fax_number": "530-533-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 OLIVE HWY",
            "address_2": "STE 12",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "95966",
            "telephone_number": "530-533-6061",
            "fax_number": "530-533-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "ROY",
        "middle_name": "CARL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C35734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0014101",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oroville, CA

Sources for this page

Verify at the official NPI Registry.