Active NPI
Rosa Short
- Contractor
- Kitts Hill, OH
National Provider Identifier
1801248125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 28344
- Practice address
- 396 Township Road 506
Kitts Hill, OH 45645-9063 - Phone
- (740) 867-4959
- NPI assigned
- Jul 11, 2016
- Last updated
- Jul 11, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 28344 | OH | Primary |
Addresses
Primary practice location
396 Township Road 506
Kitts Hill, OH 45645-9063
Mailing address
396 Township Road 506
Kitts Hill, OH 45645-9063
Phone (740) 867-4959
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 441014725201 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28344 | OH | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468195200000",
"number": "1801248125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "396 TOWNSHIP ROAD 506",
"city": "KITTS HILL",
"state": "OH",
"postal_code": "456459063",
"telephone_number": "740-867-4959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "396 TOWNSHIP ROAD 506",
"city": "KITTS HILL",
"state": "OH",
"postal_code": "456459063",
"telephone_number": "740-867-4959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORT",
"first_name": "ROSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-11",
"last_updated": "2016-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "OH",
"license": "28344",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "441014725201",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kitts Hill, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.