NPIMap

Individual provider Active NPI

Shawn E Bailey, MD

  • Family Medicine Physician
  • Granville, IL
National Provider Identifier
1447363585
Registry record updated Aug 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036081048 Issued in IL
Practice address
309 South McCoy Street
Granville, IL 61326
Phone
(815) 339-6245
Fax
(815) 339-2617
NPI assigned
Aug 15, 2006
Last updated
Aug 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036081048 IL Primary

Addresses

Primary practice location

309 South McCoy Street
Granville, IL 61326

Mailing address

600 E 1St St
Spring Valley, IL 61362-1512
Phone (815) 339-6245

Other identifiers 1

IdentifierTypeStateIssuer
036081048MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090625000330 IL Practitioner - Family Practice 2365530219 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mendota Community HospitalGroup PAC ID 2264335777, 51 clinicians

Practice addresses (Care Compare)

309 S McCoy St Osf Healthcare - Medic
Granville, IL 61326-9333
Phone (815) 538-1352

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Saint James Hospital CurrentSince Jul 10, 2023 Accepting new patients
Mendota Community Hospital CurrentSince Jul 10, 2023 Accepting new patients
City of Clinton CurrentSince Oct 15, 2023 Accepting new patients
Mendota Community Hospital Family Medicine Current Accepting new patients
Mendota Community Hospital CurrentSince Jul 10, 2023 Accepting new patients
Saint James Hospital CurrentSince Jul 10, 2023 Accepting new patients
City of Clinton CurrentSince Oct 15, 2023 Accepting new patients
K M B S C Current Accepting new patients
Mendota Community Hospital Past Accepting new patients
Osf Multi-Specialty Group Past Accepting new patients

Locations

422 W White St
Clinton, IL 61727
Phone (217) 935-9570

1404 Washington St
Mendota, IL 61342
Phone (815) 538-1825

124 SW Adams St
Peoria, IL 61602
Phone (309) 655-2850

1650 Midtown Rd
Peru, IL 61354
Phone (815) 220-1122

111 Spring St
Fl 4
Streator, IL 61364
Phone (815) 672-4587

Organizations & group practices 11

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219622400000",
    "number": "1447363585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E 1ST ST",
            "city": "SPRING VALLEY",
            "state": "IL",
            "postal_code": "613621512",
            "telephone_number": "815-339-6245",
            "fax_number": "815-339-2617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 SOUTH MCCOY STREET",
            "city": "GRANVILLE",
            "state": "IL",
            "postal_code": "61326",
            "telephone_number": "815-339-6245",
            "fax_number": "815-339-2617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "SHAWN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2008-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036081048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036081048",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granville, IL

Sources for this page

Verify at the official NPI Registry.