Shaun Cameron Dennis, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT016035 Issued in OH

Practice address

610 N Dixie Hwy
Wapakoneta, OH 45895-7739

Phone

(673) 564-3855

Fax

(419) 738-8002

NPI assigned

Aug 25, 2015

Last updated

Jan 30, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Back on Track Therapy and Wellness, LLCGroup PAC ID 0749524775, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Back on Track Therapy and Wellness, LLC

  dba Back on Track Physical Therapy

  • Physical Therapist
  • Lima, OH
  • NPI 1043739436
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1841667946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 N DIXIE HWY",
            "city": "WAPAKONETA",
            "state": "OH",
            "postal_code": "458957739",
            "telephone_number": "937-638-0354",
            "fax_number": "419-738-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N DIXIE HWY",
            "city": "WAPAKONETA",
            "state": "OH",
            "postal_code": "458957739",
            "telephone_number": "673-564-3855",
            "fax_number": "419-738-8002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4030 Allentown Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Lima",
            "state": "OH",
            "postal_code": "458072146",
            "country_code": "US",
            "telephone_number": "567-356-4385",
            "fax_number": "419-738-8002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "SHAUN",
        "middle_name": "CAMERON",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-25",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT016035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooklyn Crum
• Barbara Jill Cummins, M. D.
• Dabis Pediatrics
• Nazih Jamil Dabis, MD
• Steven Lewis Davis, RPH
• Deron Horman, M.D., Inc
• Destination Care Medical Transport, LLC
• Cynthia A Douglas
• Courtney Dowler
• Dr Eric West DC Inc

• Physical Therapist in Wapakoneta, OH
• Providers in Wapakoneta, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.