Optimum Physical Therapy & Performance Center, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

OPTIMUM PHYSICAL THERAPY & PERFORMANCE CENTER, LLC

Practice address

5501 NW 62ND Ter
Ste 102
Kansas City, MO 64151-2411

Phone

(816) 547-6140

NPI assigned

Apr 21, 2015

Last updated

Jul 30, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel S Jackson, DPTNPI 1952301756

Title

Ceo

Phone

(816) 547-6140

Specialties & licenses 1

Addresses

Other names 1

• Optimum Physical Therapy and Performance Center, LLC Other name

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Shane Jackson, DPT

  • Physical Therapist
  • Kansas City, MO
  • NPI 1952301756
  Medicare reassignment Care Compare group NPD Authorized official
• Brandi L Jackson, DPT

  • Physical Therapist
  • Kansas City, MO
  • NPI 1447209630
  Medicare reassignment Care Compare group NPD
• Tyler M Tunks, MPT

  • Physical Therapist
  • Kansas City, MO
  • NPI 1477732469
  Medicare reassignment Care Compare group NPD
• Fred E Potts IV, M.D.

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1225138456
  NPD (past)

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438214400000",
    "number": "1255728986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 NW 86TH CT",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641541283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 NW 62ND TER",
            "address_2": "STE 102",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641512411",
            "telephone_number": "816-547-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM PHYSICAL THERAPY & PERFORMANCE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-21",
        "last_updated": "2015-07-30",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "816-547-6140",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optimum Physical Therapy and Performance Center, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sarah Oprinovich, PHARMD
• Shawn Marie Oprisiu, RDH ECP III
• Madeleine Pinne Opsahl, DO
• Optimal Homecare Solutions LLC
• Optimal Outcomes, LLC
• Oral Surgery and Implant Institute Kansas City
• Lauren Ann Ori, PA-C
• Angelique Marie Orillac, MD
• Meike Orlick, R.D.
• Lindsey June Orlowski, LPC

• Physical Therapist in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.