1902244015 NPI number — DR. JENNIFER LEE KENDALL MD

Table of content: DR. JENNIFER LEE KENDALL MD (NPI 1902244015)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902244015 NPI number — DR. JENNIFER LEE KENDALL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KENDALL
Provider First Name:
JENNIFER
Provider Middle Name:
LEE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902244015
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/15/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
KANSAS UNIVERSITY PHYSICIANS INC
Provider Second Line Business Mailing Address:
3901 RAINBOW BLVD, 4070 DELP, MS 4017
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66160-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-588-2501
Provider Business Mailing Address Fax Number:
913-588-3877

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4440 BROADWAY BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64111-3315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-531-0930
Provider Business Practice Location Address Fax Number:
816-531-2807
Provider Enumeration Date:
06/11/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  04-38962 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RR0500X , with the licence number: 04-38962 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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