Mary Jane Shane-Cox, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Practice address

411 Hamilton Blvd
Suite 1824
Peoria, IL 61602-1144

Phone

(309) 494-9320

NPI assigned

Aug 20, 2006

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Central Illinois Radiological Associates, LTD.

  dba Central Illinois Radiological Associates

  • Diagnostic Radiology Physician
  • Peoria, IL
  • NPI 1538192828
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881709566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10335 N PORT WASHINGTON RD",
            "address_2": "250",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 HAMILTON BLVD",
            "address_2": "SUITE 1824",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021144",
            "telephone_number": "309-494-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANE-COX",
        "first_name": "MARY",
        "middle_name": "JANE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leena Shahbaz
• Maham Shahid, MD
• John Shallat
• Jennifer Shambaugh, PTA
• Ibrahim Shamsi, DO
• Suzan Cathleen Shane-Gray, APN, EDD
• Jayma R. Shane, CRNA
• Joshua I Shane, LPC
• Melissa A Shane, LCPC
• Peter Shanine, R.PH

• Family Nurse Practitioner in Peoria, IL
• Providers in Peoria, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.