NPI age
20 years
Enumerated 2006-02-17
● Active
Type 1 · Individual
Shannon Jenkins, DO
Jenkins is 1 of 5 pediatrics providers in Idaho Falls and 1 of 34 in Idaho.
Primary specialty
Pediatrics
Plus 2 subspecialties
Licensed in
ID, AZ, KY
3 states
Status
Active
No deactivations on record
Last NPPES update
2025-12-30
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 34 active pediatrics providers in Idaho.
NPI age
20 years
≈ at median (19 yr)
State licenses
3 states
Top 58% — 41% of peers are multi-state
Subspecialties
0
50% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-02Enumerated in NPPES
2006
2026
Where they practice
Practice location
2860 Channing Way, Suite 100
Idaho Falls, ID 834047531
Mailing address
2860 Channing Way Ste 100
Idaho Falls, ID 834047531
Additional practice locations
1 secondary location on file with NPPES.
Location 2
411 E Chestnut St
Louisville, KY 402021713
Specialties
-
Pediatrics PrimaryA pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (MT) | 0117377 | |
| 05 (WY) | 121542600 | |
| 05 (ID) | 121542600 | |
| 05 (WY) | 1285786046 |
Multi-state credentialing: Licensed in 3 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 21 other active providers share this practice address in NPPES.
Provyx · Custom healthcare lists
Need all 34 Pediatrics providers in Idaho?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.