Provider Demographics
NPI:1225759897
Name:RUSH, SHONA ROSE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SHONA
Middle Name:ROSE
Last Name:RUSH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:SHONA
Other - Middle Name:ROSE
Other - Last Name:FEISTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:118 NW LAKEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-1401
Mailing Address - Country:US
Mailing Address - Phone:417-425-0898
Mailing Address - Fax:
Practice Address - Street 1:9201 E BANNISTER RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64134-2209
Practice Address - Country:US
Practice Address - Phone:816-316-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015027112225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty