Individual provider Active NPI

Karen Sue Short, P.T.

  • Physical Therapist
  • Decatur, IN
National Provider Identifier
1053685131
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
IN05006582A Issued in IN
Practice address
105 N 13TH St
Decatur, IN 46733-1409
Phone
(260) 724-2440
Fax
(260) 724-2402
NPI assigned
Mar 6, 2012
Last updated
Mar 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X IN05006582A IN Primary
Physical Therapist 225100000X PT008652 OH

Addresses

Primary practice location

105 N 13TH St
Decatur, IN 46733-1409

Mailing address

14535 Mill Rd
Fort Wayne, IN 46816-9447
Phone (260) 639-3629

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120508000071 IN Practitioner - Physical Therapist in Private Practice 1557523644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical College of Ohio, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hands on Physical Therapy LLCGroup PAC ID 5092802041, 4 clinicians

Practice addresses (Care Compare)

1004 Woodland Plaza Run
Fort Wayne, IN 46825-1528
Phone (260) 483-1010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IN05006582AINMDPhysical Therapist
PT008652OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hands on Physical Therapy, LLC Physical Therapist CurrentSince Apr 27, 2020 Accepting new patients

Locations

1004 Woodland Plaza Run
Fort Wayne, IN 46825
Phone (260) 483-1010

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1053685131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14535 MILL RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468169447",
            "telephone_number": "260-639-3629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N 13TH ST",
            "city": "DECATUR",
            "state": "IN",
            "postal_code": "467331409",
            "telephone_number": "260-724-2440",
            "fax_number": "260-724-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "KAREN",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-06",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "IN05006582A",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT008652",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.