Active NPI
Daisy J Wagan, P.T.
- Physical Therapist
- Ballwin, MO
National Provider Identifier
1942561543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- RO756
- Practice address
- 1840 Strawberry Ridge Dr
Ballwin, MO 63021-7773 - Phone
- (314) 583-7334
- NPI assigned
- May 31, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | RO756 | MO | Primary |
Addresses
Primary practice location
1840 Strawberry Ridge Dr
Ballwin, MO 63021-7773
Mailing address
1840 Strawberry Ridge Dr
Ballwin, MO 63021-7773
Phone (314) 583-7334
Other names 1
- Daisy S Jusay
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1800 1St Capitol Dr
Apt 1
Saint Charles, MO 63301-1660
Phone (636) 242-1764
9101 N Ambassador Dr
Kansas City, MO 64154-7295
Phone (816) 631-0847
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RO756 | MO | MD | Physical Therapist |
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.
-
- Multi-Specialty Clinic/Center
- Saint Charles, MO
- NPI 1417479494
-
- Multi-Specialty Clinic/Center
- Kansas City, MO
- NPI 1083208391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338422400000",
"number": "1942561543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1840 STRAWBERRY RIDGE DR",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630217773",
"telephone_number": "314-583-7334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1840 STRAWBERRY RIDGE DR",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630217773",
"telephone_number": "314-583-7334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGAN",
"first_name": "DAISY",
"middle_name": "J",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-31",
"last_updated": "2012-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "RO756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DAISY",
"last_name": "JUSAY",
"middle_name": "S",
"credential": "P.T.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Ballwin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2012; 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.