Jennifer Shortelle, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MF000989 Issued in PA

Practice address

200 N 16TH St Apt 1901
Philadelphia, PA 19102-1211

Phone

(352) 792-8268

NPI assigned

Sep 22, 2020

Last updated

Sep 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in CO, PA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Marriage and Family Therapist

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• Psychiatry of Texas PLLC

  dba Psychplus Associates

  • Psychiatry Physician
  • Houston, TX
  • NPI 1013476027

  CO, PA

  Medicare reassignment NPD
• Psychplus Medical Associates, PLLC

  • Family Medicine Physician
  • Houston, TX
  • NPI 1558118026

  CO, PA

  Medicare reassignment NPD

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1629684832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N 16TH ST APT 1901",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021211",
            "telephone_number": "352-792-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N 16TH ST APT 1901",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021211",
            "telephone_number": "352-792-8268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORTELLE",
        "first_name": "JENNIFER",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "PA",
            "license": "MF000989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Shore
• Paul Michael Shore, MD
• Djuan Deshonge Short, LCSW
• Meg Short, PHARMD
• William R Short, MD
• Conor Patrick Shortt, MB, BCH, MSC, FRCR
• Shott Health Services
• Randy William Shott, RPH
• Kristen Shotwell
• Margaret Shotzbarger, CRNP

• Marriage & Family Therapist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Marriage & Family Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.