Individual provider Active NPI

Debra Ann Short, FNP-C

  • Family Nurse Practitioner
  • White Salmon, WA
National Provider Identifier
1154623734
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60192028 Issued in WA
Practice address
181 W. Jewett Blvd
White Salmon, WA 98672
Phone
(509) 493-1470
NPI assigned
Dec 2, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60192028 WA Primary

Addresses

Primary practice location

181 W. Jewett Blvd
White Salmon, WA 98672

Mailing address

PO Box 2319
White Salmon, WA 98672-2319
Phone (509) 493-1470

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110919000652 WA Practitioner - Nurse Practitioner 0042481392

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1154623734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2319",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "986722319",
            "telephone_number": "509-493-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 W. JEWETT BLVD",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "98672",
            "telephone_number": "509-493-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-02",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60192028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Salmon, WA

Sources for this page

Verify at the official NPI Registry.