Individual provider Active NPI

Marcus Shortes, DO

  • Emergency Medicine Physician
  • Lawton, OK
National Provider Identifier
1255894150
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
7042 Issued in OK
Practice address
3401 W Gore Blvd
Lawton, OK 73505-6332
Phone
(580) 355-8620
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 7042 OK Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3401 W Gore Blvd
Lawton, OK 73505-6332

Mailing address

3401 W Gore Blvd
Lawton, OK 73505-6332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210415002653 OK Practitioner - Emergency Medicine 7113335936 Reassigns benefits to 1 organization
I20241111003271 TX Practitioner - Emergency Medicine 7113335936 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Liberty Univ College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Century Integrated Partners, IncGroup PAC ID 6406151703, 330 clinicians

Practice addresses (Care Compare)

100 Medical Dr
Lake Jackson, TX 77566-5674
Phone (469) 420-5527

3095 Kingswood Blvd
Suite 100
Grand Prairie, TX 75052-4501
Phone (972) 854-0009

Hospital & facility affiliations

  • Ennis Regional Medical Center Hospital, Ennis, TX, CCN 450833
  • Arbuckle Memorial Hospital Authority Hospital, Sulphur, OK, CCN 371328
  • Parkview Regional Hospital Hospital, Mexia, TX, CCN 450400
  • Baylor Scott and White Emergency Hospital Hospital, Burleson, TX, CCN 670107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
7042OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Arbuckle Memorial Hospital Current Accepting new patients
Integrative Emergency Services Physician Group-Houston PLLC Emergency Medicine CurrentSince Sep 1, 2024 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

4835 Lyndon B Johnson Fwy
Ste 900
Dallas, TX 75244
Phone (469) 340-1366

540 Interstate 45 S
Ste E
Huntsville, TX 77340
Phone (936) 755-8288

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

5161 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (281) 810-9326

11713 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 793-4600

17200 St Lukes Way
The Woodlands, TX 77384
Phone (936) 266-2008

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1255894150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332",
            "telephone_number": "580-355-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORTES",
        "first_name": "MARCUS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "7042",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.