JOHN P SHANNON (MD) – Surgery Physician, NPI 1982610903

JOHN P SHANNON (MD) is a healthcare provider. based in Walla walla, Washington. specializing in GENERAL SURGERY. They hold the professional credentials MD. They hold a License No. 15136 (WA). The NPI Number for JOHN P SHANNON (MD) is 1982610903

Main info

Male
55 Years Of Experience
Accepts Medicare Assignment
Name
JOHN P SHANNON (MD)
NPI
1982610903
Phone
(509) 522-5815
Address
PO BOX 2292
Enumeration Date
31 July 2006
Last Update Date
31 March 2021

Doctor Profile

Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Secondary Phone
5098973333
Graduation Year
1971 (55 years ago)
PAC ID
4183787740
Group Practice PAC ID
2860552973
Professional Enrollment ID
I20090108000654
Address ID
WA993622924WA380XXAVEX300

Contacts

Secure Messaging
jshannon185958@wm.providencedirect.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

827 GENERAL SURGERY in WA

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Provider Addresses for JOHN P SHANNON (MD)

  • Walla Walla Post Office, 85, Commercial Street, Walla Walla, New South Wales, 2659, Australia

    WALLA WALLA, WA 99362

    Phone: (509) 522-5815

    Fax: (509) 522-5818

    Type: Mailing

  • 301, West Poplar Street, Walla Walla, Walla Walla County, Washington, 99362, United States

    SUITE 210

    WALLA WALLA, WA 99362

    Phone: (509) 522-5825

    Fax: (509) 529-3512

    Type: Location

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: 2009-01-08

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
I20090108000654IGeneral SurgeryWATBD

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 99362)

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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: 2860552973View full group profile
NameSpecialtyState
Emergency MedicineCO
Hospitalist, Internal MedicineUT
Nurse PractitionerWA
Internal Medicine, HospitalistID
N E U R O L O G YOR
Family PracticeWA
-WA
Emergency MedicineWA
Physical Therapist In Private PracticeWA
Nurse PractitionerWA

Reviews

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Frequently asked questions

Can I use this page to confirm JOHN P SHANNON (MD)'s NPI?
Yes. JOHN P SHANNON (MD) is listed with NPI 1982610903 in the public NPI dataset.
Can I rely on JOHN P SHANNON (MD) being an active provider?
As of the registry snapshot, JOHN P SHANNON (MD) is marked active.
What is JOHN P SHANNON (MD) best known for clinically?
Directory data describes JOHN P SHANNON (MD) with Surgery Physician. Clinical services aligned with this taxonomy classification.
Where is JOHN P SHANNON (MD) based?
JOHN P SHANNON (MD) is tied to Walla Walla, Washington in the data we show; additional addresses may exist on the full record.
Is the information about JOHN P SHANNON (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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