Shannon Nicole Driskell, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

14-03174 Issued in KS

Practice address

111 NW Mock Ave Ste Off
Blue Springs, MO 64014-2504

Phone

(816) 228-5655

NPI assigned

Sep 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1578047890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 POPE AVE",
            "city": "FORT LEAVENWORTH",
            "state": "KS",
            "postal_code": "660272332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NW MOCK AVE STE OFF",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640142504",
            "telephone_number": "816-228-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRISKELL",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-21",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2016002049",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KS",
            "license": "14-03174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Dorrance
• Dr Stella Fernandez
• Dr W Thomas Norman DDS P C
• Christopher Drake, DDS
• Dana S Driskell, ARNP
• Tracy Dee Dryer, RPH
• Mary Kathryn Duddridge, M.S., CCC-SP
• Margaret L Dudley
• Amanda Jo Dumers, CPNP
• Kasie Renee Durham

• Physical Therapy Assistant in Blue Springs, MO
• Providers in Blue Springs, MO by specialty
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.