Individual provider Active NPI

Jennifer Cheng, DO

  • Family Medicine Physician
  • Andover, KS
National Provider Identifier
1487811386
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6932 Issued in KS
Practice address
2117 Keystone Cir
Andover, KS 67002-8749
Phone
(316) 733-5120
Fax
(316) 733-1280
NPI assigned
May 19, 2008
Last updated
May 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6932 KS Primary

Addresses

Primary practice location

2117 Keystone Cir
Andover, KS 67002-8749

Mailing address

2117 Keystone Cir
Andover, KS 67002-8749
Phone (316) 733-5120

Other identifiers 2

IdentifierTypeStateIssuer
003719210OtherMEDICARE
200629580CMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100125000038 KS Practitioner - Family Practice 4486796810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Physicians and Surgeons, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Andover Family Medicine LLCGroup PAC ID 7012920663, 13 clinicians

Practice addresses (Care Compare)

2117 Keystone Cir
Andover, KS 67002-8749
Phone (316) 733-5120

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions12
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
6932KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Andover Family Medicine, LLC CurrentSince Dec 1, 2016 Accepting new patients

Locations

105 S Andover Rd
Ste D
Andover, KS 67002
Phone (316) 350-7735

2117 Keystone Cir
Andover, KS 67002
Phone (316) 247-5430

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1487811386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 KEYSTONE CIR",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670028749",
            "telephone_number": "316-733-5120",
            "fax_number": "316-733-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 KEYSTONE CIR",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670028749",
            "telephone_number": "316-733-5120",
            "fax_number": "316-733-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENG",
        "first_name": "JENNIFER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "6932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "003719210",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200629580C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, KS

Sources for this page

Verify at the official NPI Registry.