{"npi":"1063439743","type":"NPI-1","status":"active","name":{"display":"Shannon Buckvold MD","other":[],"first":"SHANNON","last":"BUCKVOLD","credential":"MD"},"specialty":{"primary_taxonomy":"2080P0203X","primary_taxonomy_description":"Pediatric Critical Care Medicine Physician","slug":"pediatric-critical-care-medicine-physician","schema_org_specialty":null,"all":[{"code":"2080P0203X","description":"Pediatric Critical Care Medicine Physician","primary":true,"state":"CO","license":"44614"}]},"addresses":[{"purpose":"LOCATION","street_1":"13123 E 16TH AVE","city":"AURORA","state":"CO","postal_code":"800457106","country_code":"US","phone":"7207771234"},{"purpose":"MAILING","street_1":"PO BOX 110429","city":"AURORA","state":"CO","postal_code":"800420429","country_code":"US","phone":"3034937000"}],"license":{"state":"CO","number":"44614"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"54934249","state":"CO","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20100816000763","type_code":"14-81","type_desc":"PRACTITIONER - CRITICAL CARE (INTENSIVISTS)","state":"CO","pac_id":"1557302866"}]},"enumeration_date":"2006-07-17","last_updated":"2012-09-12","_meta":{"source":"NPPES","snapshot_date":"2012-09-12","doc_url":"https://findmynpi.com/api"}}