Provider Demographics
NPI:1093981102
Name:MASSENGALE, JENNIFER CHRISITNE (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:CHRISITNE
Last Name:MASSENGALE
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 1:5800 FOXRIDGE DR
Mailing Address - Street 2:STE 240
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-2338
Mailing Address - Country:US
Mailing Address - Phone:913-261-3153
Mailing Address - Fax:
Practice Address - Street 1:4321 WASHINGTON ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5961
Practice Address - Country:US
Practice Address - Phone:816-932-2307
Practice Address - Fax:816-932-7957
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20130363902085R0202X
TXM94882085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology