Jacquelyn Gayle Short, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

7000 Issued in OH

Practice address

1001 S Defiance St
Archbold, OH 43502-1617

Phone

(419) 445-5436

Fax

(419) 446-4818

NPI assigned

Jul 28, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Optometry

Education

Southern College of Optometry, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Defiance Optometric Group IncGroup PAC ID 4789618141, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Defiance Optometric Group Inc

  • Optometrist
  • Defiance, OH
  • NPI 1255443792
  Medicare reassignment Care Compare group NPD
• Kings Vision Center

  • Optometrist
  • Archbold, OH
  • NPI 1457203614
  NPD Authorized official
• Dr. Christian a. King Optometrist, LLC

  • Optometrist
  • Archbold, OH
  • NPI 1891946158
  NPD (past)
• The Eye Care Clinic

  • Optometrist
  • Knoxville, TN
  • NPI 1184996605
  NPD (past)

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1588072003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38",
            "city": "ARCHBOLD",
            "state": "OH",
            "postal_code": "435020038",
            "telephone_number": "419-445-5436",
            "fax_number": "419-446-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S DEFIANCE ST",
            "city": "ARCHBOLD",
            "state": "OH",
            "postal_code": "435021617",
            "telephone_number": "419-445-5436",
            "fax_number": "419-446-4818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 N Clinton St Ste D",
            "address_purpose": "LOCATION",
            "city": "Defiance",
            "state": "OH",
            "postal_code": "435124611",
            "country_code": "US",
            "telephone_number": "419-782-1901",
            "fax_number": "419-782-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHORT",
        "first_name": "JACQUELYN",
        "middle_name": "GAYLE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "7000",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OH",
            "license": "7000",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "OH",
            "license": "7000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lexie Semer, M.S., CCC-SLP
• Shalom Ministries
• Casey Sharp
• Richard A Sherman, IMFT
• Shopko Stores Operating Co LLC
• Andrew Shoup, ASSISTANT PT
• Shelley Simon-Miller
• Lindsay Christine Smallman, LSW
• Rachel Renae Smith, LSW
• Tamara Snyder, NP

• Optometrist in Archbold, OH
• Providers in Archbold, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.