Individual
SHANNON R MARGHERIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
1801 N 98TH STREET, KANSAS CITY, KS 66109
(913) 717-4750
(816) 302-9939
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-03534
KS
225100000X
Physical Therapist
2005026639
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36176053
BCBS KC
—
01
—
KA2868022
MEDICARE PTAN
KS
01
—
MA4370021
MEDICARE PTAN
MO
Enumeration date
02/14/2007
Last updated
03/17/2018
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