NPIMap

Organization Active NPI

Short Family Medical Center PA

  • Primary Care Clinic/Center
  • Burleson, TX
National Provider Identifier
1609172527
Registry record updated Feb 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
K5401 Issued in TX
Legal business name
SHORT FAMILY MEDICAL CENTER PA
Practice address
101 NW Ellison St
Burleson, TX 76028-4745
Phone
(817) 295-5200
Fax
(817) 295-5210
NPI assigned
Feb 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2011

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

Authorized official

Name
Dr. Jacky Paul Short, D.O.
Title
Physician
Phone
(817) 295-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X K5401 TX Primary

Addresses

Primary practice location

101 NW Ellison St
Burleson, TX 76028-4745

Mailing address

101 NW Ellison St
Burleson, TX 76028-4745
Phone (817) 295-5200

National Provider Directory

National Provider Directory

Locations

101 NW Ellison St
Burleson, TX 76028
Phone (817) 295-5200

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9621/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297296000000",
    "number": "1609172527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NW ELLISON ST",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760284745",
            "telephone_number": "817-295-5200",
            "fax_number": "817-295-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NW ELLISON ST",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760284745",
            "telephone_number": "817-295-5200",
            "fax_number": "817-295-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORT FAMILY MEDICAL CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-10",
        "last_updated": "2011-02-10",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "JACKY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "817-295-5200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "K5401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2011; 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.