SMD Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1179278 Issued in TX

Legal business name

SMD PHYSICAL THERAPY PLLC

Practice address

2771 E Broad St Ste 211
Mansfield, TX 76063-9157

Phone

(682) 518-6263

Fax

(682) 325-3733

NPI assigned

Jul 30, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Shauna Dacus, PTNPI 1164698056

Title

Owner

Phone

(214) 801-9557

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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.

• Shauna Dacus, PT

  • Physical Therapist
  • Mansfield, TX
  • NPI 1164698056
  Medicare reassignment Authorized official
• Aubrey Starnes, PT, DPT

  • Physical Therapist
  • Mansfield, TX
  • NPI 1043956162
  NPD
• Clinton Keith Dacus, D.C.

  • Chiropractor
  • Mansfield, TX
  • NPI 1386882314
  NPD (past)
• Erica Whitlock, D.C.

  • Chiropractor
  • Mansfield, TX
  • NPI 1992951818
  NPD (past)

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406678400000",
    "number": "1821406125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2771 E BROAD ST STE 211",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639157",
            "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 STE 211",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639157",
            "telephone_number": "682-518-6263",
            "fax_number": "682-325-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMD PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-30",
        "last_updated": "2014-07-30",
        "status": "A",
        "authorized_official_last_name": "DACUS",
        "authorized_official_first_name": "SHAUNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-801-9557",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1179278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Philip Sinn, DDS
• Sherry L Sixta, MD
• Amy Skipper, M.S. CCC-SLP
• Rachel Michelle Slack, LPC
• SLH Mansfield, LLC (SLH Mansfield SNF LLC)
• Smiles of DFW PLLC (360 Dental Lounge)
• Smita Balaji Enterprise Inc (KK's Pharmacy #251)
• Barbara Smith-Jordan, LPC, LCDC
• Alexa Smith, NP
• James Smith, DPT

• Physical Therapist in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; 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.