Individual provider Active NPI

Kira McKenzie Short, PA-C

  • Physician Assistant
  • Milford, DE
National Provider Identifier
1902682909
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
100 Wellness Way
Milford, DE 19963-4364
Phone
(302) 422-3311
Fax
(302) 735-3845
NPI assigned
Sep 5, 2023
Last updated
Sep 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X DE Primary

Addresses

Primary practice location

100 Wellness Way
Milford, DE 19963-4364

Mailing address

7 Hollyberry Dr
Georgetown, DE 19947-9427

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20231102003732 DE Practitioner - Physician Assistant 4183071780 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayhealth Emergency Physicians LLCGroup PAC ID 7719240696, 80 clinicians

Practice addresses (Care Compare)

18383 Hudson Rd
Suite a
Milton, DE 19968-3103
Phone (302) 725-3500

640 S State St
Dover, DE 19901-3530

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc CurrentSince Sep 18, 2023 Accepting new patients
Bayhealth Medical Center, Inc CurrentSince Sep 18, 2023 Accepting new patients
Bayhealth Medical Center, Inc. CurrentSince Sep 18, 2023 Accepting new patients

Locations

640 S State St
Dover, DE 19901
Phone (302) 744-4700

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

401 N Carter Rd
Ste 101
Smyrna, DE 19977
Phone (302) 659-2190

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1902682909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 HOLLYBERRY DR",
            "city": "GEORGETOWN",
            "state": "DE",
            "postal_code": "199479427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WELLNESS WAY",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199634364",
            "telephone_number": "302-422-3311",
            "fax_number": "302-735-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "KIRA",
        "middle_name": "MCKENZIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, DE

Sources for this page

Verify at the official NPI Registry.