DR. SHANNON GULLEY (M.D.) – Surgery Physician, NPI 1336116821

DR. SHANNON GULLEY (M.D.) is a healthcare provider. based in Palmer, Alaska. specializing in GENERAL SURGERY. They hold the professional credentials M.D.. They hold a License No. MEDS8191 (AK). The NPI Number for DR. SHANNON GULLEY (M.D.) is 1336116821

Main info

Female
27 Years Of Experience
Accepts Medicare Assignment
Name
DR. SHANNON GULLEY (M.D.)
NPI
1336116821
Phone
(907) 745-8100
Address
2490 S WOODWORTH LOOP
Enumeration Date
2 March 2006
Last Update Date
15 July 2025

Doctor Profile

Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Secondary Phone
9077461520
Graduation Year
1999 (27 years ago)
PAC ID
5991779241
Group Practice PAC ID
2163641630
Professional Enrollment ID
I20140915001718
Address ID
AK996456463PA425XXAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Digital endpointsOther names

92 GENERAL SURGERY in AK

Provider Addresses for DR. SHANNON GULLEY (M.D.)

  • 2490 S WOODWORTH LOOP

    SUITE 450

    PALMER, AK 996457410

    Phone: (907) 745-8100

    Fax: (907) 746-2655

    Type: Mailing

  • PO BOX 75032

    CHICAGO, IL 606755032

    Phone: (907) 746-1520

    Fax: (907) 746-1521

    Type: Mailing

  • 425 E DAHLIA AVE STE J

    PALMER, AK 996456463

    Phone: (907) 746-1520

    Fax: (907) 746-1521

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 19 Open Payments records for all available years, with a total value of $2,274.

Total Amount is formed as General ($2,274) + Research ($0) + Ownership ($0) = $2,274.

Last reported payment date: 2024-05-08 • Largest payer in this snapshot: Medical Device Business Services, Inc. ($1,985).

Total Amount

$2,274

General + Research + Ownership

Payments

19

Total payment records

General Amount

$2,274

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-08

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-09-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140915001718IGeneral SurgeryAKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes9979$0
99203New patient office or other outpatient visit, 30-44 minutes8888$0
99214Established patient office or other outpatient visit, 30-39 minutes6961$0
45380Biopsy of large bowel using a flexible endoscope4847$0
43239Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope2626$0
View full utilization report →

Insurance plans in this area (ZIP 99645)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163641630View full group profile
NameSpecialtyState
General SurgeryAK
Nurse PractitionerAK

Reviews

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Frequently asked questions

Can I cross-check DR. SHANNON GULLEY (M.D.) using NPI 1336116821?
NPI 1336116821 belongs to DR. SHANNON GULLEY (M.D.); compare other details if you need extra assurance.
Is DR. SHANNON GULLEY (M.D.) shown as active in public data?
Registry records indicate DR. SHANNON GULLEY (M.D.) maintains an active NPI.
What kind of doctor is DR. SHANNON GULLEY (M.D.)?
DR. SHANNON GULLEY (M.D.) is associated with Surgery Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with DR. SHANNON GULLEY (M.D.)?
Directory geography for DR. SHANNON GULLEY (M.D.) centers on Palmer, Alaska.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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