William M Short, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301046367 Issued in MI

Practice address

1414 W Fair Ave
Ste 36
Marquette, MI 49855-2675

Phone

(906) 225-3864

Fax

(906) 225-3851

NPI assigned

Nov 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: william.short.1@8233.direct.athenahealth.com

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.

• Baraga County Memorial Hospital

  • Critical Access Hospital
  • Lanse, MI
  • NPI 1558479824
  Medicare reassignment NPD
• Baraga County Memorial Hospital

  • Family Medicine Physician
  • Lanse, MI
  • NPI 1851409643
  Medicare reassignment NPD
• DLP Marquette Physician Practices Inc

  • Obesity Medicine (Internal Medicine) Physician
  • Marquette, MI
  • NPI 1487902995

  Family Medicine

  Medicare reassignment NPD
• Baraga County Memorial Hospital

  • Emergency Medicine Physician
  • Lanse, MI
  • NPI 1508960600
  NPD
• Baraga County Memorial Hospital

  • Home Health Agency
  • Lanse, MI
  • NPI 1932218807
  NPD
• DLP Marquette Physician Practices Inc

  • Rural Health Clinic/Center
  • Marquette, MI
  • NPI 1205635760
  NPD
• Marquette General Hospital, Inc.

  • Clinical Social Worker
  • Marquette, MI
  • NPI 1710941935
  NPD

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

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240358400000",
    "number": "1720079569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 DEPT",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601220021",
            "telephone_number": "906-225-3864",
            "fax_number": "906-225-3851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "STE 36",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-3864",
            "fax_number": "906-225-3851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-01",
        "last_updated": "2009-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301046367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080036036",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1804821",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shopko Stores Operating Co LLC
• Shopko Stores Operating Co. LLC
• Shoptikal LLC
• Shoreline Supportive Counseling PLLC
• Martha J Short, M.D.
• Ross Frederick Siemers, M.D.
• Ann L. Silverman, MD
• Carol Simpson, LMSW
• Janet M Simula, CRNA
• Jennifer Margaret Simula, M.A.

• Family Medicine Physician in Marquette, MI
• Providers in Marquette, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.