Individual provider Active NPI

Wanda Peresic, PT

  • Physical Therapist
  • Kansas City, KS
National Provider Identifier
1104826957
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-02927 Issued in KS
Practice address
1150 N 75TH PL
Suite 100
Kansas City, KS 66112-3302
Phone
(913) 299-7848
Fax
(913) 299-7849
NPI assigned
Jul 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-02927 KS Primary

Addresses

Primary practice location

1150 N 75TH PL
Suite 100
Kansas City, KS 66112-3302

Mailing address

1150 N 75TH PL
Suite 100
Kansas City, KS 66112-3302
Phone (913) 299-7848

Other identifiers 1

IdentifierTypeStateIssuer
28805025OtherKSBLUECROSS BLUESHIELD

Other names 1

  • Wanda Gattshall Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-02927KSMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104826957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N 75TH PL",
            "address_2": "SUITE 100",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661123302",
            "telephone_number": "913-299-7848",
            "fax_number": "913-299-7849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 75TH PL",
            "address_2": "SUITE 100",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661123302",
            "telephone_number": "913-299-7848",
            "fax_number": "913-299-7849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERESIC",
        "first_name": "WANDA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-02927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "28805025",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "GATTSHALL",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.