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

Mrs. Shannon L Gardiner, PA

Individual provider Physician Assistant · NPI 1689701260

Mrs. Shannon L Gardiner, PA is a Physician Assistant in Meridian, Idaho. Qualified in 2002, 24 years ago. Practices with Alliance Medical Group LLC, a 130-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
24
Licensed in
ID
In the registry since
2007
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

875 S Vanguard Way Ste 200
Meridian, ID 83642-8542
Phone: (208) 809-2895
Fax: (208) 809-2896
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 360 E Montvue Dr, Meridian, ID 83642-6318 — (208) 855-2900

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA-403 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA403 (ID)

Record details

NPI number1689701260
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 28, 2007
Last updated in NPPESApril 24, 2024
Certification dateApril 24, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Alliance Medical Group Llc — 130 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Meridian