Jennifer Marie Short, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001002003 Issued in NC

Practice address

13845 Conlan Cir
Charlotte, NC 28277-2705

Phone

(704) 544-2092

NPI assigned

Oct 23, 2009

Last updated

Oct 2, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minuteclinic Diagnostic of North Carolina PCGroup PAC ID 6002837572, 208 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Minuteclinic Diagnostic of North Carolina PC

  • Family Nurse Practitioner
  • Raleigh, NC
  • NPI 1699748608
  Medicare reassignment Care Compare group
• Minuteclinic Primary Care North Carolina PLLC

  • Family Nurse Practitioner
  • Raleigh, NC
  • NPI 1356159818

  Physician Assistant

  Medicare reassignment NPD

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

{
    "created_epoch": "1256256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506902400000",
    "number": "1750617874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13845 CONLAN CIRCLE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282770060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13845 CONLAN CIR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282772705",
            "telephone_number": "704-544-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-23",
        "last_updated": "2017-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001002003",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-02003",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Igor Shorokhov
• Ashley Nicole Short, PA-C, MPH
• Brenda N Short
• Darin Short, MACC
• Donna D Short, PT, DPT
• Kathleen Ann Short, MD
• Kayla Wyrick Short, NNP-BC, RN
• Susannah Kelly Short, FNP
• Terry Short, MD
• Courtney Shorter

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2017; 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.