KEVIN A SHORT (NPI# 1881655843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881655843 |
| Entity Type | Individual |
| Full Name | KEVIN A SHORT |
| Credential | MD |
| Practice Address |
800 E Dawson St Tyler TX 75701-2036 |
| Mailing Address |
627 Turtle Creek Dr Tyler TX 75701-1832 |
| Practice Telephone | 4697571000 |
| Mailing Telephone | 9035932539 |
| Mailing Fax Number | 9035930559 |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2020-01-17 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
J0252 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 133194402 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962620807 | Kevin P Short | Preventive Medicine | 1817 I Ave, New Castle, IN 47362-2611 | 2007-04-24 |
| 1093132698 | Kevin Short | Social Worker | 5023 E 56th St, 110, Indianapolis, IN 46226-1474 | 2014-03-21 |
| 1053673897 | Kevin Short | Podiatrist | 2414 Walbert Ave, Allentown, PA 18104-1326 | 2012-06-07 |
| 1306930607 | Kevin Sean Short | Dentist | 1200 Bald Ridge Marina Rd, Suite 200, Cumming, GA 30041-8494 | 2006-10-03 |
| Street Address |
800 E DAWSON ST |
| City | TYLER |
| State | TX |
| Zip Code | 75701-2036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427051705 | Mohammad K Khedr | Internal Medicine | 800 E Dawson St, Tyler, TX 75701-2036 | 2005-05-31 |
| 1174130462 | Jessica Lemoine Phillips | Nurse Practitioner | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-09-30 |
| 1275148116 | Erika Anne Heffner | Pharmacist | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-09-08 |
| 1750995684 | Christine Vo | Pharmacist | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-09-08 |
| 1366051526 | Bessie Burchfield | Nurse Practitioner | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-07-23 |
| 1952929366 | Amy Elizabeth Enlow | Registered Nurse | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-07-13 |
| 1033739388 | Eric Bradley Vogt | Nurse Practitioner | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-04-16 |
| 1780212084 | Carolyn Victoria Hamilton | Registered Nurse | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-03-31 |
| 1548800022 | Jasmine Azghani Vardeman | Nurse Practitioner | 800 E Dawson St, Tyler, TX 75701-2036 | 2020-01-13 |
| 1346889383 | Kathy A Glem | Pharmacist | 800 E Dawson St, Tyler, TX 75701-2036 | 2019-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518220367 | Beurett Alexander King Jr. | Radiology | 1517 Cold Water Dr, Tyler, TX 75703-0937 | 2012-06-18 |
| 1093039539 | Melinda Faye Coker | Radiology | 910 E Houston St Ste 650, Tyler, TX 75702 | 2010-03-25 |
| 1548219025 | Sonowave Inc. | Radiology | 417 S Chilton Ave, Tyler, TX 75702-8017 | 2006-05-10 |
| 1427019447 | Ralph A Gutierrez | Radiology | 1021 E Watkins St, Tyler, TX 75701-7120 | 2006-03-29 |
| 1164495974 | Joe Buck Caldwell | Radiology | 520 East Douglas Blvd, Tyler, TX 75702 | 2006-02-10 |
| 1477554673 | James F. Cabell IIi | Radiology | 627 Turtle Creek Dr, Tyler, TX 75701-1832 | 2005-08-10 |
| 1871594697 | Modified Barium Swallow Service, P.a. | Radiology | 3724 Fm 346 E, Tyler, TX 75703-8340 | 2005-08-02 |
| 1962814798 | Justin Mccaslin | Radiology | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2014-05-28 |
| 1689963357 | Jose Luis Enriquez | Radiology | 627 Turtle Creek Dr, Tyler, TX 75701-1832 | 2011-04-04 |
| 1578879151 | Blake A Watson | Radiology | 627 Turtle Creek Dr, Tyler, TX 75701-1832 | 2010-08-20 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.