Stephanie Ann Short, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3012415 Issued in KY

Practice address

1907 E Pittsburg Church Rd
London, KY 40741-9047

Phone

(606) 389-5269

Fax

(606) 389-5276

NPI assigned

Dec 4, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Stephanie Ann Smith Former name

Medicare fee-for-service enrollment

Enrolled in KY

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

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

S and S Behavioral Health, LLCGroup PAC ID 2163803255, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lake Cumberland Regional Hospital Hospital, Somerset, KY, CCN 180132
• Saint Joseph London Hospital, London, KY, CCN 180011

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssbhealth@ssbh.azalea.phimailbox.com
• Direct secure messaging: stephanie.short.1@24154.direct.athenahealth.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• S & S Behavioral Health, LLC

  • Rural Health Clinic/Center
  • London, KY
  • NPI 1609634377

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership

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.

• S & S Behavioral Health, LLC

  • Primary Care Clinic/Center
  • London, KY
  • NPI 1619612231
  Medicare reassignment Care Compare group NPD Authorized official
• Practitioner Services PLLC

  • Rural Health Clinic/Center
  • London, KY
  • NPI 1821482118

  Nurse Practitioner

  Medicare reassignment NPD
• S & S Behavioral Health, LLC

  • Rural Health Clinic/Center
  • London, KY
  • NPI 1609634377
  NPD Authorized official
• Robert Hoskins, PLLC

  • Physician Assistant
  • London, KY
  • NPI 1346251691
  Medicare reassignment
• Practitioner Services PLLC

  • Rural Health Clinic/Center
  • London, KY
  • NPI 1255292819

  Psychiatric/Mental Health

  NPD

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

• Lake Cumberland Regional Hospital LLC

  • Rural Acute Care Hospital
  • Somerset, KY
  • NPI 1619038247
  Care Compare affiliation
• Saint Joseph Health System, Inc

  • Rural Acute Care Hospital
  • London, KY
  • NPI 1992701429
  Care Compare affiliation

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

{
    "created_epoch": "1417651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1154728251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 E PITTSBURG CHURCH RD",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407419047",
            "telephone_number": "606-389-5269",
            "fax_number": "606-389-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 E PITTSBURG CHURCH RD",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407419047",
            "telephone_number": "606-389-5269",
            "fax_number": "606-389-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-04",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3012415",
            "primary": true
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "KY",
            "license": "1128589",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100549240",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SMITH",
            "middle_name": "ANN",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Second Mile Behavioral Health LLC
• Ariel Leandra Sexton, DPM
• Azure Noel Shelton, APRN, PMHNP
• James M Shilling, CRNA
• Shiloh Counseling, PLLC
• Munawar Siddiqi, M.D.
• Abdul Hasan Siddiqui, M.D
• Stephen George Sigrimis
• Ariel Siler, LPCA
• Joseph Tylor Silvers, D.O.

• Psychiatric/Mental Health Nurse Practitioner in London, KY
• Providers in London, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.