Trudy M Shady, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

036-089376 Issued in IL

Practice address

4600 Memorial Dr Ste 200
Belleville, IL 62226-5363

Phone

(618) 233-2220

Fax

(618) 233-2555

NPI assigned

Aug 25, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in ND, MO, VA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: trudy.shady.1@5756.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1245277631

  Internal Medicine

  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  Medicare reassignment NPD
• Norton Community Physician Services LLC

  • Internal Medicine Physician
  • Norton, VA
  • NPI 1861674160
  Medicare reassignment NPD
• Sanford Medical Center Fargo

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924
  Medicare reassignment
• Alton Multispecialists, LTD.

  • Mammography Clinic/Center
  • Alton, IL
  • NPI 1942312442

  Internal Medicine

  NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Hollister, MO
  • NPI 1053350454

  Internal Medicine

  NPD
• Norton Community Physician Services LLC

  • Internal Medicine Physician
  • Pennington Gap, VA
  • NPI 1841098175
  NPD
• Granite City Physicians Corp

  • Clinical Medical Laboratory
  • Granite City, IL
  • NPI 1508983214
  NPD (past)
• HSHS Medical Group Inc

  • Rural Health Clinic/Center
  • Rushville, IL
  • NPI 1487719480
  NPD (past)
• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679503668
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1417940354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-257-4644",
            "fax_number": "618-257-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 MEMORIAL DR STE 200",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265363",
            "telephone_number": "618-233-2220",
            "fax_number": "618-233-2555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2044 Madison Avenue",
            "address_2": "Suite 25",
            "address_purpose": "LOCATION",
            "city": "Granite City",
            "state": "IL",
            "postal_code": "62040",
            "country_code": "US",
            "telephone_number": "618-798-8600",
            "fax_number": "618-798-8605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2044 Madison Avenue",
            "address_2": "Suite 25",
            "address_purpose": "LOCATION",
            "city": "Granite City",
            "state": "IL",
            "postal_code": "62040",
            "country_code": "US",
            "telephone_number": "618-798-8600",
            "fax_number": "618-798-8605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHADY",
        "first_name": "TRUDY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-25",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "R3L47",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-089376",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036-089376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Lucille Seaman
• Kathleen Collins Seibert, MA/LCSW
• Lindsey Michelle Senci, FNP-C
• Kimberly Lee Senters, M.A.T.
• Sewhshs Medical Group Inc.
• Megan T Shah, OT
• Niraj J Shah, M.D.
• Parvish Pradip Shah, DO
• Erum Ahad Shaikh, M.D.
• Madeline Rose Shane

• Pulmonary Disease Physician in Belleville, IL
• Providers in Belleville, IL by specialty
• Pulmonary Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.