SHANE CAUDILL (NPI# 1073900650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073900650 |
| Entity Type | Individual |
| Full Name | SHANE CAUDILL |
| Practice Address |
2600 W Main St Belleville IL 62226-6651 |
| Mailing Address |
504 Timothy Ln Carterville IL 62918-5045 |
| Practice Telephone | 6182396109 |
| Mailing Telephone | 6185210078 |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2015-04-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2600 W MAIN ST |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226-6651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780233544 | Hailey Nicole Erdman | Specialist/Technologist | 2600 W Main St, Belleville, IL 62226-6651 | 2019-09-04 |
| 1588212583 | Sydney Christine Kremer | Specialist/Technologist | 2600 W Main St, Belleville, IL 62226-6651 | 2019-09-03 |
| 1043868193 | Heather Danielle Waldemar | Student in an Organized Health Care Education/Training Program | 2600 W Main St, Belleville, IL 62226-6651 | 2019-09-03 |
| 1952959009 | Diana Nicole Shamroski | Student in an Organized Health Care Education/Training Program | 2600 W Main St, Belleville, IL 62226-6651 | 2019-09-03 |
| 1174171201 | Payton Michelle Curtis | Specialist/Technologist | 2600 W Main St, Belleville, IL 62226-6651 | 2019-09-02 |
| 1851826481 | Lauren Randazzo | Specialist/Technologist | 2600 W Main St, Belleville, IL 62226-6651 | 2017-04-20 |
| 1700310026 | Seth Vilas | Specialist/Technologist | 2600 W Main St, Belleville, IL 62226-6651 | 2017-04-13 |
| 1043743545 | Tim Woodstock | Specialist/Technologist | 2600 W Main St, Belleville, IL 62226-6651 | 2017-04-11 |
| 1316499155 | Lindenwood University-belleville | Orthopaedic Surgery | 2600 W Main St, Belleville, IL 62226-6651 | 2016-10-27 |
| 1548613300 | Stephen Curtis Wilkerson | Specialist/Technologist | 2600 W Main St, Belleville, IL 62226-6651 | 2016-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992327951 | Emily Fuhler | Student in an Organized Health Care Education/Training Program | 1681 Shadow Ridge Ct Apt 2, Belleville, IL 62221-3901 | 2020-05-13 |
| 1902428444 | Tamara Morgan-boyd | Student in an Organized Health Care Education/Training Program | 6000 W Main St, Belleville, IL 62223-4402 | 2020-05-07 |
| 1649891995 | Brooke Elise Sisk | Student in an Organized Health Care Education/Training Program | 308 S Charles St Apt A, Belleville, IL 62220-2241 | 2020-04-28 |
| 1568902831 | Jennifer Ruth Hood | Student in an Organized Health Care Education/Training Program | 35 Dewitt Ave, Belleville, NJ 07109-2507 | 2017-03-06 |
| 1548637721 | Michele Renne Tomaszewski | Student in an Organized Health Care Education/Training Program | 9460 Dalton Dr, Belleville, MI 48111-1686 | 2015-08-24 |
| 1477960789 | Esther Garrido | Student in an Organized Health Care Education/Training Program | 29 Davidson St, Belleville, NJ 07109-3207 | 2014-07-18 |
| 1518373737 | Kamel Munther Massarweh | Student in an Organized Health Care Education/Training Program | 841 Main St Apt C, Belleville, NJ 07109-3435 | 2014-07-08 |
| 1962605782 | Jason Christopher Mccarthy | Student in an Organized Health Care Education/Training Program | 180 S 3rd St Ste 400, Belleville, IL 62220-1952 | 2007-06-08 |
| 1104455609 | Kane Laks | Student in an Organized Health Care Education/Training Program | 1121 Bell West Blvd, Belleville, WI 53508 | 2020-04-06 |
| 1043849540 | Brian Kenealy | Student in an Organized Health Care Education/Training Program | 1121 Bell West Blvd, Belleville, WI 53508 | 2020-04-06 |
| Find all providers in BELLEVILLE | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
Please comment or provide details below to improve the information on SHANE CAUDILL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.