NPIMap

Individual provider Active NPI

Jeffrey Keith Short

  • Diagnostic Radiology Physician
  • Mount Pleasant, SC
National Provider Identifier
1538110663
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
21549 Issued in SC
Practice address
1241 Woodland Avenue
Mount Pleasant, SC 29464
Phone
(843) 824-0606
Fax
(843) 824-0909
NPI assigned
May 13, 2006
Last updated
Jul 14, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 21549 SC Primary

Addresses

Primary practice location

1241 Woodland Avenue
Mount Pleasant, SC 29464

Mailing address

1241 Woodland Avenue
Mount Pleasant, SC 29464
Phone (843) 824-0606

Other identifiers 2

IdentifierTypeStateIssuer
215494MedicaidSC
300128417OtherMEDICARE RR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071015000541 SC Practitioner - Diagnostic Radiology 3274538442 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical University of South Carolina College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Radiologists PAGroup PAC ID 9436054715, 35 clinicians

Practice addresses (Care Compare)

1241 Woodland Ave
Mount Pleasant, SC 29464-3288
Phone (843) 824-0606

2550 Elms Ctr Rd
North Charleston, SC 29406-9844
Phone (866) 717-9687

295 Midland Pkwy
Summerville, SC 29485-8104
Phone (866) 717-9687

501 Robertson Blvd
Walterboro, SC 29488-2787
Phone (866) 717-9687

8330 Medical Plaza Dr
Charleston, SC 29406-9104
Phone (866) 717-9687

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.62 of 100Reported as group
Quality
79.55
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.22 of 100Reported as group
Quality
95.56
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21849SCMDOphthalmology Physician
21549SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Radiologists PA Diagnostic Radiology CurrentSince Mar 3, 2008 Accepting new patients
Diagnostic Radiology of Charleston LLP Diagnostic Radiology Past Accepting new patients
Roper Radiologists PA Diagnostic Radiology PastSince Nov 13, 2022 Accepting new patients

Locations

1241 Woodland Ave
Mt Pleasant, SC 29464
Phone (843) 881-4020

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1538110663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 WOODLAND AVENUE",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "29464",
            "telephone_number": "843-824-0606",
            "fax_number": "843-824-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 WOODLAND AVENUE",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "29464",
            "telephone_number": "843-824-0606",
            "fax_number": "843-824-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "JEFFREY",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "21549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215494",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "300128417",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.