Mark S Short, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2011012296 Issued in MO

Practice address

126 Missouri Ave
MCXP-CCS-CR
Fort Leonard Wood, MO 65473-8952

Phone

(573) 596-0417

Fax

(573) 596-0524

NPI assigned

Jul 25, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

80.94 of 100Reported as group

Quality

61.89

Promoting interoperability

100

Improvement activities

40

Cost

74.58

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• University of Pittsburgh Physicians

  • Diagnostic Radiology Physician
  • Pittsburgh, PA
  • NPI 1285692699
  NPD
• University of Pittsburgh Physicians

  • Urgent Care Clinic/Center
  • Franklin, PA
  • NPI 1619381456
  NPD

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1194748863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 MISSOURI AVE",
            "address_2": "MCXP-CCS-CR",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654738952",
            "telephone_number": "573-596-0417",
            "fax_number": "573-596-0524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 MISSOURI AVE",
            "address_2": "MCXP-CCS-CR",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654738952",
            "telephone_number": "573-596-0417",
            "fax_number": "573-596-0524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2011012296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Traci Anne Shambo, RDH
• Anne Sheahan
• Rebecca Shepard
• Christina Ann Shepherd
• Alma Delia Short
• David Shoup
• William Brian Shurtleff, FNP-C
• Lydia Sickbert, MD
• Isatu Kamara Sidibe
• Victoria Dawn Simms

• Physician Assistant in Fort Leonard Wood, MO
• Providers in Fort Leonard Wood, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.