MEDICARE: BLUE ZONE PHYSICAL THERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1518819127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE ZONE PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	7600 NE 103RD TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64157-8067
Country	:	US
Telephone Number	:	913-608-7568
Fax Number	:

Provider Business Practice Location Address
First Line	:	7600 NE 103RD TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64157-8067
Country	:	US
Telephone Number	:	913-608-7568
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WILLIE LEE PARKER III
Credential	:	DPT
Telephone Number	:	913-608-7568

Provider Enumeration Date	:	02/14/2026
Last Update Date	:	02/14/2026

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