NPIMap

Individual provider Active NPI

Walter M Short, M.D.

  • Family Medicine Physician
  • Paragould, AR
National Provider Identifier
1649295833
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E1907 Issued in AR
Practice address
4000 Linwood Dr Ste a
Paragould, AR 72450-7224
Phone
(870) 239-8503
Fax
(870) 236-1947
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E1907 AR Primary

Addresses

Primary practice location

4000 Linwood Dr Ste a
Paragould, AR 72450-7224

Mailing address

4000 Linwood Dr
Suite a
Paragould, AR 72450-7223
Phone (870) 239-8503

Other identifiers 1

IdentifierTypeStateIssuer
135484001MedicaidAR

Other names 1

  • Walter M Short Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20080325000694 AR Practitioner - Emergency Medicine 3476639832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Arkansas College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Health Group, IncGroup PAC ID 7315844586, 23 clinicians

Practice addresses (Care Compare)

4000 Linwood Dr
Paragould, AR 72450-7224
Phone (870) 239-8503

4000 Linwood Dr
Paragould, AR 72450-8894

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E1907ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Health Group, Inc CurrentSince Jul 5, 2016 Accepting new patients
St Bernards Physician Clinics Inc Current Accepting new patients
Crossett Health Foundation Past Accepting new patients
St Bernards Hospital Inc. Past Accepting new patients
Crossett Health Foundation Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

1001 W Parker Rd
Jonesboro, AR 72404
Phone (870) 336-1700

415 E Matthews Ave
Jonesboro, AR 72401

225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630

333 Red Wolf Blvd
Jonesboro, AR 72405
Phone (870) 933-1823

111 S Main St
Leachville, AR 72438
Phone (870) 539-1115

4000 Linwood Dr
Ste A
Paragould, AR 72450
Phone (870) 239-8503

Interoperability endpoints

  • Direct secure messaging: waltershort@sbpc.medalliesdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1649295833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 LINWOOD DR",
            "address_2": "SUITE A",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724507223",
            "telephone_number": "870-239-8503",
            "fax_number": "870-236-1947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 LINWOOD DR STE A",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724507224",
            "telephone_number": "870-239-8503",
            "fax_number": "870-236-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "WALTER",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2024-02-28",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E1907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135484001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WALTER",
            "last_name": "SHORT",
            "middle_name": "M",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Paragould, AR

Sources for this page

Verify at the official NPI Registry.