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

Mr. Shannon R Peck, MD

Individual provider Diagnostic Radiology Physician · NPI 1083819650

Mr. Shannon R Peck, MD is a Diagnostic Radiology in Sioux Falls, South Dakota. Graduated from University of Kansas School of Med (KC/WICH/SAL) in 2011, 15 years ago. Practices with Sanford Clinic, a 273-clinician group and accepts Medicare assignment. Licensed in South Dakota.

Years since qualifying
15
Trained at
University of Kansas School of Med (KC/WICH/SAL)
Licensed in
SD
In the registry since
2007
Specialties on file
2
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

1210 W 18th St Ste LL03
Sioux Falls, SD 57104-4647
Phone: (605) 328-1410
Fax: (605) 328-1412
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 8389 (SD)
Vascular & Interventional Radiology Physician Taxonomy 2085R0204X · Licence 8389 (SD)

Record details

NPI number1083819650
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 15, 2007
Last updated in NPPESSeptember 8, 2025
Certification dateSeptember 8, 2025

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolUNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated 2011 (15 years in practice)
Group practice Sanford Clinic — 273 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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