Provider Demographics
NPI:1730497769
Name:EVERETT, MEGAN E (DPT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:EVERETT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:WEATHERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16157 ENGLAND ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66085-7864
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11940 W 119TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2216
Practice Address - Country:US
Practice Address - Phone:913-563-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-03827225100000X
CA33-0209580225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA056630OtherMEDICARE CERTIFIED SITE (THERAPY SPECIALISTS)