Individual provider Active NPI

Rande Kent Short, MD

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1831177039
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26031 Issued in CO
Practice address
15680 Wildwood CT
Colorado Springs, CO 80921-3740
Phone
(814) 746-2420
NPI assigned
Jan 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD45722 IA
Family Medicine Physician 207Q00000X 26031 CO Primary

Addresses

Primary practice location

15680 Wildwood CT
Colorado Springs, CO 80921-3740

Mailing address

15680 Wildwood CT
Colorado Springs, CO 80921-3740
Phone (814) 746-2420

Other practice location 1

112 Jefferson St
West Union, IA 52175-1022
Phone (563) 422-9703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20181217001000 IA Practitioner - Emergency MedicinePractitioner - Family Practice 5092795385 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26031COMDFamily Medicine Physician
MD45722IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Health - Mercy Hospital, Corning, Iowa CurrentSince Dec 11, 2018 Accepting new patients
Seven Hills Emergency Group, PC CurrentSince Apr 20, 2021 Accepting new patients
Alegent Health - Mercy Hospital, Corning Iowa Family Medicine Current Accepting new patients
Palmer Lutheran Health Center, Inc. Family Medicine CurrentSince Jan 30, 2019 Accepting new patients
Alegent Health Mercy Hospital Corning, Iowa Family Medicine CurrentSince Dec 11, 2018 Accepting new patients
Alegent Health - Mercy Hospital, Corning Iowa Current Accepting new patients
Decatur County Hospital CurrentSince Sep 9, 2022 Accepting new patients
Cumberland Clinic SC Family Medicine Past Accepting new patients
Michael a Rowley MD PA Past Accepting new patients

Locations

603 Rosary Dr
Corning, IA 50841
Phone (641) 322-3121

1000 W Lincoln Way
Jefferson, IA 50129
Phone (515) 386-2114

210 S Main St
Lenox, IA 50851
Phone (641) 333-2266

1405 NW Church St
Leon, IA 50144
Phone (641) 446-2340

112 Jefferson St
West Union, IA 52175
Phone (563) 422-3811

Interoperability endpoints

  • Direct secure messaging: rshort306467@direct.gundersenhealth.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1831177039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15680 WILDWOOD CT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809213740",
            "telephone_number": "814-746-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15680 WILDWOOD CT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809213740",
            "telephone_number": "814-746-2420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Jefferson St",
            "address_purpose": "LOCATION",
            "city": "West Union",
            "state": "IA",
            "postal_code": "521751022",
            "country_code": "US",
            "telephone_number": "563-422-9703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHORT",
        "first_name": "RANDE",
        "middle_name": "KENT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "MD45722",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "26031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.