Individual provider Active NPI

J Randall Short, DC

  • Chiropractor
  • Lexington, VA
National Provider Identifier
1447357355
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104000441 Issued in VA
Practice address
30 Crossing Lane
Suite 207
Lexington, VA 24450-6354
Phone
(540) 464-5800
Fax
(540) 464-5801
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104000441 VA Primary

Addresses

Primary practice location

30 Crossing Lane
Suite 207
Lexington, VA 24450-6354

Mailing address

30 Crossing Lane
Suite 207
Lexington, VA 24450-6354
Phone (540) 464-5800

Other identifiers 1

IdentifierTypeStateIssuer
063073OtherVAANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spine Care of Tidewater PC Chiropractor Past Accepting new patients
Spine Care of Tidewater, P.C. Chiropractor Past Accepting new patients
Chiropractic and Primary Spine Care of Lexington Chiropractor PastSince Apr 5, 2020 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447357355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CROSSING LANE",
            "address_2": "SUITE 207",
            "city": "LEXINGTON",
            "state": "VA",
            "postal_code": "244506354",
            "telephone_number": "540-464-5800",
            "fax_number": "540-464-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CROSSING LANE",
            "address_2": "SUITE 207",
            "city": "LEXINGTON",
            "state": "VA",
            "postal_code": "244506354",
            "telephone_number": "540-464-5800",
            "fax_number": "540-464-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "J",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104000441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "063073",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, VA

Sources for this page

  • 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.