Active NPI
Charles D. Short Jr., NP
- Nurse Practitioner
- Pleasanton, CA
National Provider Identifier
1033301718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 647464
- Practice address
- 5000 Hopyard Rd
Suite 100
Pleasanton, CA 94588-3348 - Phone
- (925) 924-1600
- NPI assigned
- Aug 15, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 647464 | TX | Primary |
Addresses
Primary practice location
5000 Hopyard Rd
Suite 100
Pleasanton, CA 94588-3348
Mailing address
5000 Hopyard Rd
Suite 100
Pleasanton, CA 94588-3348
Phone (925) 924-1600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 647464 | Other | TX | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 647464 | TX | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187136000000",
"number": "1033301718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 HOPYARD RD",
"address_2": "SUITE 100",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945883348",
"telephone_number": "925-924-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 HOPYARD RD",
"address_2": "SUITE 100",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945883348",
"telephone_number": "925-924-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORT",
"first_name": "CHARLES",
"middle_name": "D.",
"name_suffix": "Jr.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-15",
"last_updated": "2007-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "647464",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "647464",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pleasanton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.