JACQUELINE KELLY SHANE (DPT) – Physical Therapist, NPI 1205721362

JACQUELINE KELLY SHANE (DPT) is a healthcare provider. based in Overland park, Kansas. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 11-07890 (KS). The NPI Number for JACQUELINE KELLY SHANE (DPT) is 1205721362

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
JACQUELINE KELLY SHANE (DPT)
NPI
1205721362
Phone
(913) 319-7600
Address
8889 W 75TH ST
Enumeration Date
10 June 2025
Last Update Date
24 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9133227828
Graduation Year
2025 (1 year ago)
PAC ID
3072026186
Group Practice PAC ID
1153225479
Professional Enrollment ID
I20250701004633
Address ID
KS662042206OV8889XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

1,046 PHYSICAL THERAPIST IN PRIVATE PRACTICE in KS

Provider Addresses for JACQUELINE KELLY SHANE (DPT)

  • 8889 W 75TH ST

    OVERLAND PARK, KS 662042206

    Phone: (913) 319-7600

    Fax: (913) 253-1702

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250701004633IPhysical Therapist In Private PracticeKSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 66204)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153225479View full group profile
NameSpecialtyState
Orthopedic SurgeryKS
Orthopedic Surgery, Hand SurgeryKS
Orthopedic SurgeryKS
Sports Medicine, Orthopedic SurgeryKS
Orthopedic SurgeryKS
Orthopedic Surgery, Sports MedicineKS
-KS
Orthopedic SurgeryKS
-KS
Physical Therapist In Private PracticeMO

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What identifier follows JACQUELINE KELLY SHANE (DPT) across health systems?
The NPI 1205721362 uniquely identifies JACQUELINE KELLY SHANE (DPT) in U.S. healthcare data.
Is JACQUELINE KELLY SHANE (DPT) currently accepting referrals based on NPI status?
Registry metadata lists JACQUELINE KELLY SHANE (DPT) as active.
What does the directory say JACQUELINE KELLY SHANE (DPT) does?
Insurance directories may phrase it differently, but here JACQUELINE KELLY SHANE (DPT) maps to Physical Therapist. Clinical services aligned with this taxonomy classification.
Can patients visit JACQUELINE KELLY SHANE (DPT) in Overland Park, Kansas?
For routing, start with Overland Park, Kansas for JACQUELINE KELLY SHANE (DPT), then verify phone and hours locally.
Can I export JACQUELINE KELLY SHANE (DPT)'s record?
You can download the official NPPES record; we summarize key fields for readability.

Similar Providers

KELLY M EHRNMAN (RPT)

Physical Therapist
9211, Moody Park Drive, Overland Park, Johnson County, Kansas, 66212, United States
NPI: 1932191764
West 112th Street, Overland Park, Johnson County, Kansas, 66251, United States
NPI: 1316934631

TERESA S ROSE (R.P.T.)

Physical Therapist
15100, Metcalf Avenue, Stanley, Overland Park, Johnson County, Kansas, 66223, United States
NPI: 1023005345
West 112th Street, Overland Park, Johnson County, Kansas, 66251, United States
NPI: 1750378071

LISSA F WINDHORST (R.P.T.)

Physical Therapist
West 112th Street, Overland Park, Johnson County, Kansas, 66251, United States
NPI: 1124015441
West 112th Street, Overland Park, Johnson County, Kansas, 66251, United States
NPI: 1477540797
10351, Barkley Street, Overland Park, Johnson County, Kansas, 66212, United States
NPI: 1790767630
Keller Springs Road, Carrollton, Dallas County, Texas, 75248, United States
NPI: 1467434043
Keller Springs Road, Carrollton, Dallas County, Texas, 75248, United States
NPI: 1811979495