Timothy Ryan Short, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704335486 Issued in MI

Practice address

146 S Charles St
Adrian, MI 49221-2556

Phone

(517) 366-5000

Fax

(517) 366-5002

NPI assigned

Sep 13, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Toledo College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Promedica Central Corporation of MichiganGroup PAC ID 7012902265, 112 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring Home health agency, Jackson, MI, CCN 237274
• Promedica Charles and Virginia Hickman Hospital Hospital, Adrian, MI, CCN 230005

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tshort113193@direct.promedica.org

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.

• Promedica Central Corporation of Michigan

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1588624696

  MI

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Emma L. Bixby Medical Center

  • General Acute Care Hospital
  • Adrian, MI
  • NPI 1972564730
  Care Compare affiliation
• Great Lakes Home Health Services, Inc.

  • Home Health Agency
  • Jackson, MI
  • NPI 1588642110
  Care Compare affiliation

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1114696069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 S CHARLES ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492212556",
            "telephone_number": "517-366-5000",
            "fax_number": "517-366-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 S CHARLES ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492212556",
            "telephone_number": "517-366-5000",
            "fax_number": "517-366-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "TIMOTHY",
        "middle_name": "RYAN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-13",
        "last_updated": "2023-11-03",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704335486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tshort113193@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shemick Chiropractic Center PC
• Gregory Paul Shemick, DC
• Shelley Mae Shepherd, DC
• Steven Anthony Sherman, M.D.
• Shirley Goodlock
• Douglas Shotsky, PC
• Lesley Shulman, ATC
• Sherman Shultz, MD
• Tariq A. Siddiqi, MD
• Kevin Siemen

• Family Nurse Practitioner in Adrian, MI
• Providers in Adrian, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.