Individual provider Active NPI

Candace N Short, CRNP

  • Family Medicine Physician
  • Dothan, AL
National Provider Identifier
1407919822
Registry record updated Nov 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1-079259 Issued in AL
Practice address
500 Healthwest Dr
Dothan, AL 36303-6900
Phone
(334) 699-5994
Fax
(334) 699-5995
NPI assigned
Dec 18, 2006
Last updated
Nov 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1079259 AL
Family Medicine Physician 207Q00000X 1-079259 AL Primary

Addresses

Primary practice location

500 Healthwest Dr
Dothan, AL 36303-6900

Mailing address

4370 W Main St
Dothan, AL 36305-1056
Phone (334) 793-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20070507000691 AL Practitioner - Nurse Practitioner 2769588789 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Neurospine and Vascular Institute LLCGroup PAC ID 8123515582, 3 clinicians

Practice addresses (Care Compare)

102 Doctors Dr
Dothan, AL 36301-2911
Phone (334) 793-6573

1118 Ross Clark Cir
Suite 704
Dothan, AL 36301-3030
Phone (334) 824-3098

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1079259ALMDSpecialist
1-079259ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obstetrics & Gynecology of Dothan Inc CurrentSince Oct 25, 2014 Accepting new patients
Elite Neurospine & Vascular Institute LLC CurrentSince Sep 2, 2025 Accepting new patients
Womens Healthcare of Dothan PC Specialist CurrentSince Aug 5, 2018 Accepting new patients
Houston County Healthcare Authority Family Medicine CurrentSince Mar 11, 2024 Accepting new patients
Houston County Healthcare Authority Family Medicine Current Accepting new patients

Locations

102 Doctors Dr
Dothan, AL 36301
Phone (334) 793-8804

104 Medical Dr
Dothan, AL 36303
Phone (334) 671-9445

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

1118 Ross Clark Cir
Ste 704
Dothan, AL 36301
Phone (334) 794-5335

1458 Whatley Dr
Dothan, AL 36303
Phone (334) 671-9445

4300 W Main St
Ste 31
Dothan, AL 36305
Phone (334) 793-6511

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699142400000",
    "number": "1407919822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051056",
            "telephone_number": "334-793-5000",
            "fax_number": "334-615-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HEALTHWEST DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363036900",
            "telephone_number": "334-699-5994",
            "fax_number": "334-699-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "CANDACE",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2023-11-05",
        "certification_date": "2023-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "1079259",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "1-079259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.