Provider Demographics
NPI:1427166834
Name:CAGLE, PERRI E (PT)
Entity type:Individual
Prefix:
First Name:PERRI
Middle Name:E
Last Name:CAGLE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:
Mailing Address - City:STILWELL
Mailing Address - State:KS
Mailing Address - Zip Code:66085-0307
Mailing Address - Country:US
Mailing Address - Phone:866-249-9736
Mailing Address - Fax:
Practice Address - Street 1:3901 RAINBOW BLVD MSC 4043
Practice Address - Street 2:2032 SCHOOL OF NURSING
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:866-249-9736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00808225100000X
KS1101411225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
23585027OtherBCBS PROVIDER NUMBER
S29280Medicare UPIN
KSM029609Medicare ID - Type Unspecified