Individual provider Active NPI

Shauna Dacus, PT

  • Physical Therapist
  • Mansfield, TX
National Provider Identifier
1164698056
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1179278 Issued in TX
Practice address
2771 E Broad St
211
Mansfield, TX 76063-9156
Phone
(682) 518-6263
Fax
(682) 325-3733
NPI assigned
May 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1179278 TX Primary

Addresses

Primary practice location

2771 E Broad St
211
Mansfield, TX 76063-9156

Mailing address

2771 E Broad St
211
Mansfield, TX 76063-9156
Phone (682) 518-6263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081021000453 TX Practitioner - Physical Therapist in Private Practice 2163580010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2500 E Broad St
Suite 106
Mansfield, TX 76063-4361
Phone (682) 518-6263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dacus Chiropractic PLLC PastSince Aug 23, 2023 Accepting new patients
Proactive Physical Therapy Centers, PLLC Physical Therapist PastSince Sep 14, 2009 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1164698056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2771 E BROAD ST",
            "address_2": "211",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639156",
            "telephone_number": "682-518-6263",
            "fax_number": "682-325-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2771 E BROAD ST",
            "address_2": "211",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639156",
            "telephone_number": "682-518-6263",
            "fax_number": "682-325-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACUS",
        "first_name": "SHAUNA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-01",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1179278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.