ROY CARL SHANNON (MD) – Internal Medicine Physician, NPI 1104880335

ROY CARL SHANNON (MD) is a healthcare provider. based in Oroville, California. specializing in Internal Medicine Physician. They hold the professional credentials MD. They hold a License No. C35734 (CA). The NPI Number for ROY CARL SHANNON (MD) is 1104880335

Main info

Male
54 Years Of Experience
Accepts Medicare Assignment
Name
ROY CARL SHANNON (MD)
NPI
1104880335
Phone
(530) 533-6061
Address
2721 OLIVE HWY
Enumeration Date
14 April 2006
Last Update Date
7 March 2023

Doctor Profile

Medical School Name
UNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
Secondary Phone
5305331554
Graduation Year
1972 (54 years ago)
PAC ID
4981512969
Group Practice PAC ID
4082501192
Professional Enrollment ID
I20080114000330
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for ROY CARL SHANNON (MD)

  • 2721, Olive Highway, Oroville, Butte County, California, 95966, United States

    STE 12

    OROVILLE, CA 95966

    Phone: (530) 533-6061

    Fax: (530) 533-4438

    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: 2008-01-14

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
I20080114000330IInternal MedicineCATBD

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 95966)

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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: 4082501192View full group profile
NameSpecialtyState
Internal Medicine, HospitalistCA
General SurgeryCA
Physician AssistantCA
O P H T H A L M O L O G YCA
General SurgeryCA
Family PracticeCA
G A S T R O E N T E R O L O G YCA
Internal MedicineNV
N E P H R O L O G YNY
Certified Registered Nurse Anesthetist (Crna)CA

Reviews

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Frequently asked questions

How do I look up ROY CARL SHANNON (MD) by NPI?
Use NPI 1104880335 when you need to reference ROY CARL SHANNON (MD) in forms, claims, or directories.
Is ROY CARL SHANNON (MD) currently active in the NPI registry?
CMS-published data lists ROY CARL SHANNON (MD) as an active registrant.
What does ROY CARL SHANNON (MD) treat or focus on?
Patients typically see ROY CARL SHANNON (MD) under the specialty Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for ROY CARL SHANNON (MD)?
The page summarizes Oroville, California for ROY CARL SHANNON (MD); expand the address list for detail.
Is ROY CARL SHANNON (MD) a real provider?
This page reflects official NPPES data for NPI 1104880335. Always confirm identity and privileges with the practice and licensing boards.

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