Elizabeth A Daze, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1103763 Issued in KS

Practice address

6640 Johnson Dr
Mission, KS 66202-2617

Phone

(913) 384-5810

Fax

(913) 384-0719

NPI assigned

Jun 6, 2006

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Serc of Johnson County LLC

  • Physical Therapist
  • Olathe, KS
  • NPI 1952359390
  NPD (past)
• Mid America Balance Institute of Cass County Missouri

  • Respiratory/Developmental/Rehabilitative Specialist/Technologist
  • Belton, MO
  • NPI 1902050511
  NPD (past)
• Spine and Extremity Rehabilitation Center of Raytown Inc

  • Physical Therapist
  • Raytown, MO
  • NPI 1568410165
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

• Elizabeth A Schukman Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 21, 2017.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1104865997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6640 JOHNSON DR",
            "city": "MISSION",
            "state": "KS",
            "postal_code": "662022617",
            "telephone_number": "913-384-5810",
            "fax_number": "913-384-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAZE",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2006021634",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "1103763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "KA2868025",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC",
            "identifier": "37204058",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MA4370060",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "SCHUKMAN",
            "middle_name": "A",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Julie Cunningham, LMFT
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• All providers in Mission, KS
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.