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

Individual provider Physician Assistant · NPI 1346531928

Shannon Peck, PA-C is a Physician Assistant in American Fork, Utah. Qualified in 2010, 16 years ago. Practices with Keith Mark Gross MD Inc, a 4-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
16
Licensed in
UT
In the registry since
2011
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1159 E 200 N #250
American Fork, UT 84003-2022
Phone: (801) 855-2980
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 7890710-1206 (UT)

Record details

NPI number1346531928
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedApril 29, 2011
Last updated in NPPESApril 29, 2011

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Keith Mark Gross Md Inc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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