Shannon R. Staker, MD
Pediatrics Physician · Roosevelt, UT
Shannon R. Staker, MD is a pediatrics physician with a practice address in Roosevelt, Utah, and NPI 1023078045, issued on Mar 24, 2006. Check the license (Utah 49110641205, as entered in NPPES) on the Utah Medical Licensing Board; the Medicare figures below come from public CMS files.
- Name
- Shannon R. Staker
- Credential
- MD
- Primary taxonomy
- Pediatrics Physician 208000000X
- License number
- 49110641205 UT
Self-reported in NPPES; status is on the state search - Practice location
- 210 W 300 N 75-3, Roosevelt, UT 84066
- Phone
- (435) 722-3971
- Enumerated
- Mar 24, 2006
- Record last updated
- Jul 13, 2026
- Fax
- (435) 722-6104
- Medicaid ID
- D3849 UT
- Medicare enrollment
- Enrolled (PECOS I20251202000229); accepts Medicare assignment
- Medical or professional school
- University Of Utah School Of Medicine, 1997
- Entity
- Type 1 · individual
8 nearest pediatrics physician records → All 670 in Utah → Look up another NPI →
Also registered at 210 W 300 N 75-3
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Jason Beales, MDPediatrics Physician1891755872
- Michael Catten, MDOtolaryngology Physician1861452070
- Bradley Jenkins, FNPNurse Practitioner1912968538
- Darwin McKee, P.A.-CPhysician Assistant1023079910
- Lawrence Morrill, DOFamily Medicine Physician1497715593
- John Nolte, MDObstetrics & Gynecology Physician1194786095
Verify Shannon R. Staker in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersUtah Medical Licensing Board
Search for license 49110641205Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
One hospital affiliation
- Uintah Basin Medical CenterRoosevelt, UT · Acute Care Hospitals2 of 5 stars
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through); hospitals matched to CMS Hospital General Information (Care Compare) (data.cms.gov). Star ratings are CMS hospital ratings, not ratings of this provider.
Shannon R. Staker among 670 pediatrics physician records in Utah
Shannon R. Staker, MD is one of 670 pediatrics physician records with a practice address in Utah. 37% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2006, is newer than 11% of them.
- NPI issued2006 · 11% of these records are older, 58% newer
- In a Medicare fileYes · 37% of these records are
- In the CMS Doctors and Clinicians fileYes · 9% of these records are
- Graduated1997 · median 2009 among the 57 with a school on file
- Record last updated2026 · 62% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 208000000X and a Utah practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
3 pediatrics physician records list a practice address in Roosevelt
They are 3 of the 190 NPPES records with a practice address in Roosevelt, and 670 pediatrics physician records in Utah.
All 670 in Utah → Every provider in Roosevelt → Pediatrics Physician nationwide →
The 8 pediatrics physician records with the nearest ZIP codes
- Jason Beales, MDRoosevelt, UT 840661891755872
- Gregory Staker, MDRoosevelt, UT 840661275593717
- John Allred, DORoy, UT 840671336136977
- Jonathan Atzet, MDRiverton, UT 840651730290636
- Marcus Blackburn, M.D.Riverton, UT 840651598919409
- J Duffy, MDRiverton, UT 840651376654285
- Kristina Esham, MDRiverton, UT 840651164533071
- Melissa Kadish, MDRiverton, UT 840651073907119
Common questions
What is Shannon R. Staker, MD's NPI number?
Shannon R. Staker, MD's National Provider Identifier (NPI) is 1023078045, issued on Mar 24, 2006. An NPI identifies a provider in billing; it is not a license.
Where is Shannon R. Staker, MD located?
The NPPES record lists a practice address at 210 W 300 N 75-3, Roosevelt, UT, 84066. Phone: (435) 722-3971. Providers update this record themselves, so call before visiting.
How can I verify Shannon R. Staker, MD's license?
NPPES lists Utah license number 49110641205, as entered by the provider. Search the Utah Medical Licensing Board at https://secure.utah.gov/llv/search/index.html. The NPPES record confirms identity only; the state search shows license status, expiration and public orders.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.