Shannon Smith Sovndal

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

DR.0041265 Issued in CO

Practice address

1100 Balsam Ave
Boulder, CO 80304-3404

Phone

(303) 440-2037

NPI assigned

Dec 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Shannon S. Sovndal Professional name

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Boulder Community Health

  • General Acute Care Hospital
  • Boulder, CO
  • NPI 1821074196
  Medicare reassignment NPD
• Boulder Emergency Physicians PC

  • Emergency Medicine Physician
  • Boulder, CO
  • NPI 1659354637
  Medicare reassignment NPD
• Emergency Professionals of Colorado, PC

  • Emergency Medicine Physician
  • Loveland, CO
  • NPI 1396496469
  Medicare reassignment NPD
• Boulder Community Health

  • Psychiatry Physician
  • Boulder, CO
  • NPI 1083799928

  Emergency Medicine

  NPD
• Boulder Community Health

  • Primary Care Clinic/Center
  • Boulder, CO
  • NPI 1740837137
  NPD
• Boulder Emergency Physicians PC

  • Emergency Medicine Physician
  • Lafayette, CO
  • NPI 1407454317
  NPD
• Emergency Professionals of Colorado, PC

  • Emergency Medicine Physician
  • Greeley, CO
  • NPI 1366835415
  NPD
• Boulder Community Health

  • Multi-Specialty Clinic/Center
  • Boulder, CO
  • NPI 1609822030
  NPD (past)
• Carepoint P.C.

  • Emergency Medicine Physician
  • Denver, CO
  • NPI 1275516346
  NPD (past)
• Longs Peak Emergency Physicians, PC

  • Emergency Medicine Physician
  • Longmont, CO
  • NPI 1215910146
  NPD (past)
• Quantum Plus LLC

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1235188962
  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1912984394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 173894",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "803043404",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BALSAM AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043404",
            "telephone_number": "303-440-2037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOVNDAL",
        "first_name": "SHANNON",
        "middle_name": "SMITH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "41265",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR.0041265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86032330",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00019485",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "SOVNDAL",
            "middle_name": "S.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• South Boulder Healing Center PLLC
• South Boulder Pediatric Dentistry
• Jeffrey Aaron South, DPT
• Teresa Southard, PT
• Southpointe Family Resource Center, P.C.
• Spacious Soul Counseling LLC
• Alyssa Marie Spampinato, NONE
• Rye Lynne Spanton, LPCC
• Carol Spar, PSY.D.
• Spark of Serenity, LLC

• Emergency Medicine Physician in Boulder, CO
• Providers in Boulder, CO by specialty
• Emergency Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.