Shane Rainey, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036.144466 Issued in IL

Practice address

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Phone

(309) 655-2274

NPI assigned

May 2, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, AZ, WY3 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 Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/dcf3b1c6-3971-4673-962e-8b2cce0ff827/

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.

• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment NPD
• Banner Hospital Based Physicians West LLC

  • Multi-Specialty Clinic/Center
  • Casper, WY
  • NPI 1619464120
  Medicare reassignment NPD
• Banner Physician Super Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1841573870
  Medicare reassignment NPD
• Banner-University Medical Group

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508809427

  Family Medicine

  Medicare reassignment NPD
• Board of Trustees of the University of Illinois

  • Pediatrics Physician
  • Peoria, IL
  • NPI 1467425322
  NPD
• The Board of Trustees of the University of Illinois

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• Banner Hospital Based Physicians West LLC

  • Multi-Specialty Clinic/Center
  • Ogallala, NE
  • NPI 1144025446
  NPD
• Banner Physician Super Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Mesa, AZ
  • NPI 1386462810
  NPD
• Banner-University Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1922820935
  NPD
• Banner - University Medical Center Tucson Campus LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1265820179
  NPD (past)
• Banner Desert Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1720011810
  NPD (past)
• Banner Gateway Medical Center

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1699884858
  NPD (past)

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

{
    "created_epoch": "1430524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1588041164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 W CARROUSEL LN",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152860",
            "telephone_number": "630-882-5719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINEY",
        "first_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-02",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.144466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zainab Syyeda Rahmat, MD, M.B.B.S.
• Molly Sue Rahn, DT/H
• Katherine Sue Rahoy, D.P.T.
• Timothy Grant Raines, M.D.
• Pilar McKay Rainey, D.O.
• Edward C. Rainville, PHARMMS
• Deena R Raithel, APN
• Jessica Neha Rajkumar
• Arjit Singh Rajpal, M.B.B.S
• Rajiv Chekuri Raju, M.D.

• Pediatrics Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; 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.