Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Shannon R Staker, MD

Individual provider Pediatrics Physician · NPI 1023078045

Dr. Shannon R Staker, MD is a Pediatric Medicine in Roosevelt, Utah. Graduated from University of Utah School of Medicine in 1997, 29 years ago. Practices with Uintah Basin Medical Center, a 60-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
29
Trained at
University of Utah School of Medicine
Licensed in
UT
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

210 W 300 N 75-3
Roosevelt, UT 84066
Phone: (435) 722-3971
Fax: (435) 722-6104
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 49110641205 (UT)

Record details

NPI number1023078045
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 24, 2006
Last updated in NPPESJuly 13, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolUNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated 1997 (29 years in practice)
Group practice Uintah Basin Medical Center — 60 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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