KEVIN L SHADY MD NPI 1245317304

NPI Information

NPI: 1245317304
Provider Name: KEVIN L SHADY, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
915 N GRAND BLVD
SAINT LOUIS, MO
ZIP 63106
Phone: (314) 652-4100
Get Directions

Kevin L Shady, MD is a diagnostic radiology radiology in Saint Louis, MO. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Kevin L Shady, MD NPI is 1245317304. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

915 N GRAND BLVD
SAINT LOUIS, MO
ZIP 63106-621
Phone: (314) 652-4100

The NPI 1245317304 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 3/12/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	036088119	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	300066968	OTHER		RR CARE
2	300066973	OTHER		RR CARE
3	1390	OTHER	MISSOURI	BLUE
4	208893503	MEDICAID	MISSOURI
5	398004	OTHER		HLT PART
6	46068	OTHER		HCARE USA
7	0360881191	MEDICAID	ILLINOIS
8	2781	OTHER		GHP
9	F70866	OTHER		GATE WAY
10	431725842MID	OTHER		MERCY
11	0006021895	OTHER	ILLINOIS	BLUE
12	18177	OTHER		BLUER CHOICE
13	1609006	OTHER		PH PLAN
14	251709	OTHER		H LINK
15	300066978	OTHER		RR CARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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