Active NPI
Martha Short, ATC, LAT
- Athletic Trainer
- Middleburg, FL
National Provider Identifier
1215021555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL1270
- Practice address
- 2620 Blanding Blvd
Suite 28
Middleburg, FL 32068-5185 - Phone
- (904) 282-8640
- Fax
- (904) 282-8696
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL1270 | FL | Primary |
Addresses
Primary practice location
2620 Blanding Blvd
Suite 28
Middleburg, FL 32068-5185
Mailing address
1011 Orangewood Rd
Jacksonville, FL 32259-3160
Phone (904) 287-4649
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL1270 | FL | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H2 Rehabilitation Services of Florida LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Rehabilitation Clinic/Center
- West Melbourne, FL
- NPI 1366269144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215021555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 ORANGEWOOD RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322593160",
"telephone_number": "904-287-4649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2620 BLANDING BLVD",
"address_2": "SUITE 28",
"city": "MIDDLEBURG",
"state": "FL",
"postal_code": "320685185",
"telephone_number": "904-282-8640",
"fax_number": "904-282-8696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORT",
"first_name": "MARTHA",
"name_prefix": "Mrs.",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL1270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middleburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.