Active NPI
Brian J Short, NP
- Nurse Practitioner
- Richmond, IN
National Provider Identifier
1073588844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 71001054A
- Practice address
- 4620 Middleboro Lane
Richmond, IN 47374 - Phone
- (765) 966-1391
- NPI assigned
- Feb 23, 2006
- 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 | 71001054A | IN | Primary |
Addresses
Primary practice location
4620 Middleboro Lane
Richmond, IN 47374
Mailing address
4620 Middleboro Lane
Richmond, IN 47374
Phone (765) 966-1391
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000731844 | Other | IN | ANTHEM BCBS |
| 200361020 | Medicaid | IN |
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 |
|---|---|---|---|
| 71001054A | IN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Past | Accepting new patients | |
| Meridian Health Services Corp. | Past | Accepting new patients | |
| Neurology Indiana LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
-
- Federally Qualified Health Center (FQHC)
- Montpelier, IN
- NPI 1417838574
-
- Neurology Physician
- Indianapolis, IN
- NPI 1427145010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471478400000",
"number": "1073588844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4620 MIDDLEBORO LANE",
"city": "RICHMOND",
"state": "IN",
"postal_code": "47374",
"telephone_number": "765-966-1391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4620 MIDDLEBORO LANE",
"city": "RICHMOND",
"state": "IN",
"postal_code": "47374",
"telephone_number": "765-966-1391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORT",
"first_name": "BRIAN",
"middle_name": "J",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-23",
"last_updated": "2016-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71001054A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000731844",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200361020",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richmond, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.