Christy D. Short, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

60834-21 Issued in WI

Practice address

N2950 State Road 67
Lake Geneva, WI 53147-2655

Phone

(262) 245-0535

Fax

(262) 245-2248

NPI assigned

May 12, 2010

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WI, IL, ND3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Emergency Medicine

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

Moundview Memorial Hospital and Clinics, Inc.Group PAC ID 1355250432, 50 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gundersen Moundview Hospital and Clinics Hospital, Friendship, WI, CCN 521309
• Mercy Walworth Hospital & Medical Center Hospital, Lake Geneva, WI, CCN 521357

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cshort481232@direct-ehr-ssmhc.com
• Direct secure messaging: cshort471925@direct.emplifyhealth.org

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.

• Mercy Health System Corporation

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603

  IL, WI

  Medicare reassignment Care Compare group NPD
• Mercy Health System Corporation

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550

  WI

  Medicare reassignment Care Compare group NPD
• Moundview Memorial Hospital & Clinics, Inc

  • Critical Access Hospital
  • Friendship, WI
  • NPI 1710939533

  WI

  Medicare reassignment Care Compare group NPD
• Froedtert Manitowoc Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Manitowoc, WI
  • NPI 1437829975

  WI

  Medicare reassignment NPD
• Gundersen Clinic LTD

  • Clinic/Center
  • La Crosse, WI
  • NPI 1851343115

  WI

  Medicare reassignment NPD
• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1225873458

  WI

  Medicare reassignment NPD
• Memorial Hospital of Boscobel

  • Critical Access Hospital
  • Boscobel, WI
  • NPI 1760459846

  WI

  Medicare reassignment NPD
• St. Joseph'S Health Services, Inc.

  • Clinic/Center
  • Hillsboro, WI
  • NPI 1104031798

  WI

  Medicare reassignment NPD
• Tomah Memorial Hospital Inc

  • Critical Access Hospital
  • Tomah, WI
  • NPI 1184765240

  WI

  Medicare reassignment NPD
• Tomah Memorial Hospital Inc

  • Critical Access Hospital
  • Tomah, WI
  • NPI 1992970453

  Emergency Medicine, WI

  Medicare reassignment NPD
• Tri-County Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Whitehall, WI
  • NPI 1417201864

  WI

  Medicare reassignment NPD
• Altru Health System

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1043309552

  ND

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Health System Corporation

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550

  Hospital

  Care Compare affiliation
• Moundview Memorial Hospital & Clinics, Inc

  • Critical Access Hospital
  • Friendship, WI
  • NPI 1710939533

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1659699833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N2950 STATE ROAD 67",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472655",
            "telephone_number": "262-245-0535",
            "fax_number": "262-245-2248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17495 La Grange Rd",
            "address_purpose": "LOCATION",
            "city": "Tinley Park",
            "state": "IL",
            "postal_code": "604877581",
            "country_code": "US",
            "telephone_number": "708-406-3243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHORT",
        "first_name": "CHRISTY",
        "middle_name": "D.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-12",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036138762",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "60834-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSWI",
            "identifier": "1659699833",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659699833",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "388608210 1",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCYCARE INSURANCE",
            "identifier": "SHORTCHR",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Shaffner, FNP-BC
• Farah Shaukat, MD
• Mitchell Sheley, MD
• Loretta Shem, RN, BSN
• Anna M. Sherman, OT
• Blenda Shulka, LPN
• Marni B Shumaker, RD, CD
• Henry A. Sibbing, J.D., M.S.
• Jessica M Siczkowycz, CPM, LM
• Kurtis James Siemsen, DC

• All providers in Lake Geneva, WI
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.