Individual provider Active NPI

Traci Kaye Lawler-Shortt, APRN

  • Nurse Practitioner
  • Decatur, TX
National Provider Identifier
1255694121
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP121618 Issued in TX
Practice address
609 Medical Center Dr
Decatur, TX 76234-3836
Phone
(940) 627-5921
Fax
(940) 626-1351
NPI assigned
Jun 16, 2012
Last updated
Jun 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP121618 TX Primary
Acute Care Nurse Practitioner 363LA2100X 630971 TX

Addresses

Primary practice location

609 Medical Center Dr
Decatur, TX 76234-3836

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

Other names 1

  • Traci Kaye Shortt Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120913000801 TX Practitioner - Nurse Practitioner 5395993455 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP121618TXMDNurse Practitioner
630971TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Palo Pinto County Hospital District Acute Care CurrentSince Jul 9, 2012 Accepting new patients
Palo Pinto County Hospital District Current Accepting new patients
Wise Emergency Medicine Associates PA Nurse Practitioner CurrentSince Feb 15, 2013 Accepting new patients
Palo Pinto County Hospital District CurrentSince Jul 9, 2012 Accepting new patients
Palo Pinto County Hospital District Current Accepting new patients
Palo Pinto County Hospital District Nurse Practitioner Current Accepting new patients
Primecare Emergency Center - Arlington LLC Past Accepting new patients

Locations

200 Corporate Blvd
Lafayette, LA 70508

609 Medical Center Dr
Decatur, TX 76234
Phone (940) 626-1360

400 SW 25th Ave
Mineral Wells, TX 76067
Phone (940) 325-7891

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1339804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1255694121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 MEDICAL CENTER DR",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343836",
            "telephone_number": "940-627-5921",
            "fax_number": "940-626-1351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWLER-SHORTT",
        "first_name": "TRACI",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-16",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP121618",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "630971",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "SHORTT",
            "middle_name": "KAYE",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Decatur, TX

Sources for this page

Verify at the official NPI Registry.