MR. FREDRICK WILLIAM SHORT DO NPI 1780637868

NPI Information

NPI: 1780637868
Provider Name: MR. FREDRICK WILLIAM SHORT, DO
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
21107 DONAHOO RD
TONGANOXIE, KS
ZIP 66086
Phone: (913) 742-4084
Get Directions

MR. Fredrick William Short, DO is a family medicine in Tonganoxie, KS. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MR. Fredrick William Short, DO NPI is 1780637868. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

21107 DONAHOO RD
TONGANOXIE, KS
ZIP 66086-153
Phone: (913) 742-4084
Fax: (913) 742-4086

The enumeration date for this NPI number is 5/18/2006 and was last updated on 9/24/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		R4C55	MISSOURI	No
2	207Q00000X	Family Medicine		0520840	KANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	380001404	MEDICARE ID-TYPE UNSPECIFIED		RAILROAD
2	09549174	OTHER		BCBS
3	110478	MEDICARE PIN	KANSAS
4	C52055	MEDICARE UPIN
5	100230280C	MEDICAID	KANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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