Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1023078045 Individual Practitioner Female Practitioner

Dr. Shannon R Staker , MD

Pediatrics • Roosevelt, UT

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Shannon Staker, MD is a certified Pediatrics practicing in Roosevelt, UT. With approximately 29 years of clinical experience since graduating from University Of Utah School Of Medicine in 1997, Dr. Staker delivers high-quality medical care to the local community at 210 W 300 N 75-3.

Dr. Staker is affiliated with Uintah Basin Medical Center and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

210 W 300 N 75-3

Roosevelt, UT 84066

Telephone 4357223971
Fax 4357226104
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

University Of Utah School Of Medicine

Graduation Year

1997

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Roosevelt, UT

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
29 Yrs Matches City Avg
City Avg: 29.0 Yrs
State Avg: 21.9 Yrs
Regional Practice Density
3 Specialists

Practicing in Roosevelt, UT (688 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Staker (29 Years) 29 Yrs
Roosevelt Specialty Average (29.0 Years) 29.0 Yrs

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License UT 49110641205

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
D3849 (UT)

Hospital & Practice Group Affiliations

Uintah Basin Medical Center

210 W 300, Roosevelt, UT 840662336

Uintah Basin Medical Center

250 W 300, Roosevelt, UT 840662336

Phone: 4357224691

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

16 Associated Practitioners
Darwin Mckee , PA-C

Physician Assistant

NPI 1023079910

Physician Assistant (Certified)

Lori Teem , FNP

Nurse Practitioner

NPI 1083675649

Family Nurse Practitioner

Dr. John Nolte , MD

Obstetrics & Gynecology

NPI 1194786095

Doctor of Medicine (M.D.)

Dr. Gary White , MD

Family Medicine

NPI 1205897196

Doctor of Medicine (M.D.)

NPI 1275593717

Doctor of Medicine (M.D.)

Dr. James White , MD

Physical Medicine & Rehabilitation

NPI 1316908122

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 210 W 300 N 75-3, ROOSEVELT, UT 84066 (Tel: 4357223971)

📍
Updated Business Mailing Address July 08, 2007

Registered at 210 W 300 N 75-3, ROOSEVELT, UT 84066 (Tel: 4357223971)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as SHANNON STAKER, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Pediatrics (License #49110641205 in UT)

🟢
Initial NPI Registration & Enumeration March 24, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1023078045
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 24, 2006
Last Update: July 13, 2026
Sole Proprietor: No

Mailing Address

210 W 300 N 75-3

Roosevelt, UT 84066

Phone: 4357223971

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.