Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Daniel Shane Jackson, DPT

Individual provider Physical Therapist · NPI 1952301756

Daniel Shane Jackson, DPT is a Physical Therapist in Private Practice in Kansas City, Missouri. Qualified in 2006, 20 years ago. Practices with Optimum Physical Therapy and Performance Center LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Kansas and Missouri.

Years since qualifying
20
Licensed in
KS, MO
In the registry since
2005
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

5501 NW 62nd Ter Ste 102
Kansas City, MO 64151-2412
Phone: (816) 453-4485
Fax: (816) 453-4101
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 11-03205 (KS)
Physical Therapist Taxonomy 225100000X · Licence 2002029465 (MO)

Record details

NPI number1952301756
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedJuly 22, 2005
Last updated in NPPESOctober 6, 2022
Certification dateOctober 6, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Optimum Physical Therapy And Performance Center Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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