SHANNON EDMONDS ARDOIN (MD) – Diagnostic Radiology Physician, NPI 1053575506

SHANNON EDMONDS ARDOIN (MD) is a healthcare provider. based in Little rock, Arkansas. specializing in DIAGNOSTIC RADIOLOGY. They hold the professional credentials MD. They hold a License No. E-4819 (AR). The NPI Number for SHANNON EDMONDS ARDOIN (MD) is 1053575506

Main info

Female
Sole Proprietor
24 Years Of Experience
Accepts Medicare Assignment
Name
SHANNON EDMONDS ARDOIN (MD)
NPI
1053575506
Phone
(501) 960-2422
Address
44 COLONY RD
Enumeration Date
14 July 2008
Last Update Date
9 June 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3187371090
Graduation Year
2002 (24 years ago)
PAC ID
1355402306
Group Practice PAC ID
3779559984
Professional Enrollment ID
I20090808000112
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:17State licenses:2Digital endpointsOther names

380 DIAGNOSTIC RADIOLOGY in AR

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Provider Addresses for SHANNON EDMONDS ARDOIN (MD)

  • 44, Colony Road, Colony West, Little Rock, Pulaski County, Arkansas, 72227, United States

    LITTLE ROCK, AR 722272947

    Phone: (501) 960-2422

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-04-03

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

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
I20081209000339IDiagnostic RadiologyMSTBD
I20090808000112IDiagnostic RadiologyLATBD
I20240403001454IDiagnostic RadiologyARTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72227)

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Provider's Procedures

SHANNON EDMONDS ARDOIN (MD) performs procedures in DIAGNOSTIC RADIOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYAR71010X-ray of chest, 1 view, front559469
DIAGNOSTIC RADIOLOGYAR71250CT scan chest6362
DIAGNOSTIC RADIOLOGYAR73110X-ray of wrist, minimum of 3 views1818
DIAGNOSTIC RADIOLOGYAR74177CT scan of abdomen and pelvis with contrast2222

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: 3779559984View full group profile

Reviews

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Frequently asked questions

How do payers reference SHANNON EDMONDS ARDOIN (MD)?
For SHANNON EDMONDS ARDOIN (MD), use NPI 1053575506 as the unique 10-digit identifier.
Active or inactive — what applies to SHANNON EDMONDS ARDOIN (MD)?
You should see SHANNON EDMONDS ARDOIN (MD) as active in CMS-hosted NPPES data.
How would a patient describe SHANNON EDMONDS ARDOIN (MD)'s focus?
For SHANNON EDMONDS ARDOIN (MD), the primary taxonomy reads as Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
Is SHANNON EDMONDS ARDOIN (MD) located near Little Rock?
SHANNON EDMONDS ARDOIN (MD) currently maps to Little Rock, Arkansas in this extract.
Does SHANNON EDMONDS ARDOIN (MD) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.