Roberta Rae Short, ETC

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

12033 Agency Rd
Parker, AZ 85344-7718

Phone

(928) 662-4718

NPI assigned

Apr 20, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225255987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PHS INDIAN HOSPITAL",
            "address_2": "12033 AGENCY RD",
            "city": "PARKER",
            "state": "AR",
            "postal_code": "853449703",
            "telephone_number": "928-662-4718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12033 AGENCY RD",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853447718",
            "telephone_number": "928-662-4718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "ROBERTA",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "ETC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ilan Shamos, DMD
• Lilly Shimahara, DPM
• Shawntel Shirley
• Nattareeya Shontz, RN
• Arnie Ray Short, L.I.S.A.C.
• Eric E Sisam, APRN, CRNA
• Matthew Ruhmann Slater, MPH
• Randall B. Smith, D.D.S.
• Renee Smith, DNP, NP-C
• Shazia Sohrawardy, DO

• Personal Care Attendant in Parker, AZ
• Providers in Parker, AZ by specialty
• Personal Care Attendant in Arizona

• 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.

Verify at the official NPI Registry.