Provider Demographics
NPI:1801835871
Name:FROST, JENNIFER (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:FROST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6013 LEAVENWORTH RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66104-1436
Mailing Address - Country:US
Mailing Address - Phone:913-222-2308
Mailing Address - Fax:133-866-6229
Practice Address - Street 1:6013 LEAVENWORTH RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66104-1436
Practice Address - Country:US
Practice Address - Phone:913-222-2308
Practice Address - Fax:913-386-6622
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003022695207Q00000X
KS04-30435207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208743716Medicaid
KS200307980BMedicaid
KS200307980BMedicaid
MOH71349Medicare UPIN
MOP00275256Medicare ID - Type UnspecifiedRAILROAD MEDICARE