Dr Taylor Russel Short, DDS is a medicare enrolled "Dentist" provider in Fordland, Missouri. His current practice location is
1059 Barton Dr, Fordland, Missouri. You can reach out to his office (for appointments etc.) via phone at
(417) 767-2273.
Dr Taylor Russel Short is licensed to practice in Missouri (license number 2020018039) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1235751652.
Healthcare Provider's Profile
| Full Name | Dr Taylor Russel Short |
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| Gender | Male |
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| Speciality | Dentist |
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| Location | 1059 Barton Dr, Fordland, Missouri |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1235751652
- Provider Enumeration Date: 05/07/2020
- Last Update Date: 08/10/2021
Medicare PECOS Information:
- PECOS PAC ID: 3870916372
- Enrollment ID: I20200630002498
Medical Identifiers
Medical identifiers for Dr Taylor Russel Short such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1235751652 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 122300000X | Dentist | 7336 (Oklahoma) | Secondary |
| 122300000X | Dentist | 2020018039 (Missouri) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Taylor Russel Short allows following entities to bill medicare on his behalf.
| Entity Name | Advocates For A Healthy Community Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1558303057
PECOS PAC ID: 5395653562
Enrollment ID: O20041109000631 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Taylor Russel Short is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Taylor Russel Short, DDS
1059 Barton Dr,
Fordland, MO 65652-7350
Ph: (417) 767-2273 | Dr Taylor Russel Short, DDS
1059 Barton Dr,
Fordland, MO 65652-7350
Ph: (417) 767-2273 |
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