| Daniel Shane Jackson, DPT | |
|
5501 Nw 62nd Ter Ste 102, Kansas City, MO 64151-2412 | |
| (816) 453-4485 | |
| (816) 453-4101 |
| Full Name | Daniel Shane Jackson |
|---|---|
| Gender | Male |
| Speciality | Physical Therapy |
| Experience | 18 Years |
| Location | 5501 Nw 62nd Ter Ste 102, Kansas City, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952301756 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 2002029465 (Missouri) | Secondary |
| 225100000X | Physical Therapist | 11-03205 (Kansas) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Optimum Physical Therapy And Performance Center Llc | 1052625340 | 3 |
| Provider Name | Optimum Physical Therapy & Performance Center Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1255728986 PECOS PAC ID: 1052625340 Enrollment ID: O20150730012459 |
| Mailing Address | Practice Location Address |
|---|---|
| Daniel Shane Jackson, DPT 5501 Nw 62nd Ter Ste 102, Kansas City, MO 64151-2412 Ph: (816) 453-4485 | Daniel Shane Jackson, DPT 5501 Nw 62nd Ter Ste 102, Kansas City, MO 64151-2412 Ph: (816) 453-4485 |
Dr. Scott Lawrence Jones, DPT, MHA, OCS Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 912 W 78th St, Kansas City, MO 64114 Phone: 816-305-0030 | |
Paula Dianne Walsh, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 406 Armour Rd Ste 200, Kansas City, MO 64116 Phone: 816-895-9126 Fax: 816-895-5436 | |
Julie Musick, MS,PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2401 Gillham Rd, Kansas City, MO 64108 Phone: 816-234-3380 Fax: 816-346-1372 | |
Erin Leigh Mooney, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 13157 State Line Rd, Kansas City, MO 64145 Phone: 816-941-2550 Fax: 816-941-2520 | |
Judith E Vinlove Hutchison, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6758 Pennsylvania Ave, Kansas City, MO 64113 Phone: 816-914-4868 | |
Ms. Kati Mayer, D.P.T. Physical Therapist Medicare: Medicare Enrolled Practice Location: 10008 Walnut Dr., #202, Kansas City, MO 64114 Phone: 479-685-6768 | |
Sophie Dehaven, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4700 Belleview Ave Ste 415, Kansas City, MO 64112 Phone: 816-569-2802 |