Individual provider Active NPI

Brian Short, DPM

  • Podiatrist
  • Fairfield, OH
National Provider Identifier
1336116383
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36003369 Issued in OH
Practice address
6200 Pleasant Ave
Suite 3
Fairfield, OH 45014-4670
Phone
(513) 829-9333
Fax
(513) 858-7827
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36003369 OH Primary

Addresses

Primary practice location

6200 Pleasant Ave
Suite 3
Fairfield, OH 45014-4670

Mailing address

3000 Hospital Dr
Batavia, OH 45103-1921
Phone (513) 735-8924

Other identifiers 1

IdentifierTypeStateIssuer
2502661MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040625001069 OH Practitioner - Podiatry 2860478229 Practice locations: Batavia, OH; Georgetown, OH

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3000 Hospital Dr
Batavia, OH 45103-1921
Phone (513) 735-8924

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue255
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36003369OHMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Foot and Ankle Specialists of Ohio Inc Podiatrist Past Accepting new patients
Advanced Foot Surgeons, Inc. Past Accepting new patients
Neurology Associates of Southern Ohio LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bshort18493@direct.bsmhealth.org
  • Direct secure messaging: bshort@brianshortdpm.emadirect.md

Organizations & group practices 3

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 2

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1336116383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 HOSPITAL DR",
            "city": "BATAVIA",
            "state": "OH",
            "postal_code": "451031921",
            "telephone_number": "513-735-8924",
            "fax_number": "513-732-8348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 PLEASANT AVE",
            "address_2": "SUITE 3",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450144670",
            "telephone_number": "513-829-9333",
            "fax_number": "513-858-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "BRIAN",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36003369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2502661",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.