Mark Philo Short, PSY.D.

Primary specialty

School PsychologistTaxonomy code 103TS0200X

Practice address

2780 S Jones Blvd Ste 108
Las Vegas, NV 89146-5625

Phone

(702) 606-3295

NPI assigned

Apr 3, 2008

Last updated

Aug 4, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Integrated Psychological Solutions LLC

  • Clinical Psychologist
  • Las Vegas, NV
  • NPI 1104379882
  Medicare reassignment NPD
• Sun City Hospice Inc

  • Community Based Hospice Care Agency
  • Las Vegas, NV
  • NPI 1104517036
  NPD (past)

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1124291778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 S JONES BLVD STE 108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465625",
            "telephone_number": "702-606-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 S JONES BLVD STE 108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465625",
            "telephone_number": "702-606-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "MARK",
        "middle_name": "PHILO",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-03",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PY0780",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shooting Stars Behavioral Health LLC
• Ryan Shopshire
• Shorelines
• Short Term House 1 of NV LLC
• Cristina Short-Henzon, RN
• Marqueisha Short
• Yolanda Short
• Doris Shorter
• Jacqueline Shorter
• Tiffany Shorter

• School Psychologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• School Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.