Charles D Short, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

R5909 Issued in MO

Practice address

3015 N Ballas Rd
Department of Pathology
Saint Louis, MO 63131-2329

Phone

(314) 996-4285

Fax

(314) 996-5551

NPI assigned

Feb 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Parkway Pathology Group

  • Anatomic Pathology & Clinical Pathology Physician
  • Sullivan, MO
  • NPI 1750580510
  NPD (past) Authorized official
• Digestive Disease Medical Consultants, PC

  • Gastroenterology Physician
  • Lake St Louis, MO
  • NPI 1407960107
  NPD (past)

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1568438398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 500720",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631500720",
            "telephone_number": "314-989-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-4285",
            "fax_number": "314-996-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "CHARLES",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "R5909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy R Shores, SLP
• Darla Roye Shores, MD
• Sarah B Shores
• Stephanie Lynn Shorey, WHNP-BC
• Alexis Short, MSW
• Christa Short
• Elisabeth Short
• Jennifer Lea Short, APRN
• Ryan Short, MD
• Tonia D. Short, LCSW

• Anatomic Pathology & Clinical Pathology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Anatomic Pathology & Clinical Pathology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.