Shannon Reynolds, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A135859 Issued in CA

Practice address

Corner of Route N12 and N7
Fort Defiance, AZ 86504

Phone

(928) 729-8132

NPI assigned

Sep 16, 2015

Last updated

Jan 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, TX2 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

Emergency Medicine

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Fort Defiance Indian Hospital Board, IncorporationGroup PAC ID 0941336697, 153 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fort Defiance Indian Hospital Hospital, Ft. Defiance, AZ, CCN 030071

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• The Fort Defiance Indian Hospital Board, Incorporation

  dba Fort Defiance Indian Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1477876639

  TX

  Medicare reassignment Care Compare group NPD
• Emergency Specialist Physicians Medical Associates, Inc

  • Emergency Medicine Physician
  • Torrance, CA
  • NPI 1518917913
  Medicare reassignment NPD
• Pinnacle Emergency Physicians of Bakersfield, a Professional Corp

  dba Pinnacle Emergency Physicians of Bakersfield A Professional

  • Emergency Medicine Physician
  • Bakersfield, CA
  • NPI 1619153251
  Medicare reassignment NPD
• The Fort Defiance Indian Hospital Board, Incorporation

  dba Fort Defiance Indian Hospital

  • Ambulatory Surgical Clinic/Center
  • Fort Defiance, AZ
  • NPI 1487977914
  NPD
• Pinnacle Emergency Physicians of Bakersfield, a Professional Corp

  • Emergency Medicine Physician
  • Bakersfield, CA
  • NPI 1639415862
  NPD

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674864000000",
    "number": "1376912618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 AND N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "928-729-8132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2023-01-28",
        "certification_date": "2023-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A135859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shannon.anderson@fdihb.org",
            "affiliation": "Y",
            "endpointDescription": "Work Email",
            "affiliationName": "Fort Defiance Indian Hospital",
            "address_1": "Corner of Route N12 and N7",
            "city": "Fort Defiance",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "86504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kevin David Reeves, PT
• Vincent A Regan, RRT, RCP
• Louella M Regis, MD
• Iris Rendon, RT
• William Reno, CRNA
• June Ellen Rhoda, APRN-NP
• Lauren Richardson
• Lindsey L Riggs, PA
• Christine A Rizkalla, DMD
• Hannah Robb

• Emergency Medicine Physician in Fort Defiance, AZ
• Providers in Fort Defiance, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2023; 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.