Provider Demographics
NPI:1295095248
Name:PERRY, BRET STEPHEN (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRET
Middle Name:STEPHEN
Last Name:PERRY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:6749 SW 29TH ST STE B
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-5657
Practice Address - Country:US
Practice Address - Phone:785-730-3784
Practice Address - Fax:785-730-3786
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-04461225100000X
KST032912251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
858471OtherOPTUM
51622018OtherBCBS-KC
KSKA2868070OtherMEDICARE PTAN
KSUSES NPIOtherBCBS-KANSAS