Individual provider Active NPI

Colleen Glennon, MD

  • Student in an Organized Health Care Education/Training Program
  • Kansas City, MO
National Provider Identifier
1609638147
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2301 Holmes St
Kansas City, MO 64108-2640
Phone
(816) 404-4175
NPI assigned
Jan 30, 2024
Last updated
Jun 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PENDING MO
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

2301 Holmes St
Kansas City, MO 64108-2640

Mailing address

7732 Pawnee Dr
Prairie Village, KS 66208-4116
Phone (913) 744-9008

Other practice location 1

350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone (602) 406-3000

Other practice location 2

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5011

Other practice location 3

2411 Holmes St
Kansas City, MO 64108-2741
Phone (816) 404-0950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20250707000966 MO Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5395259014

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: cglennon675272@direct.saint-lukes.org

NPI Registry JSON

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1609638147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7732 PAWNEE DR",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662084116",
            "telephone_number": "913-744-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 HOLMES ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082640",
            "telephone_number": "816-404-4175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 W Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850134409",
            "country_code": "US",
            "telephone_number": "602-406-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2601 E Roosevelt St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850084973",
            "country_code": "US",
            "telephone_number": "602-344-5011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2411 Holmes St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641082741",
            "country_code": "US",
            "telephone_number": "816-404-0950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLENNON",
        "first_name": "COLLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.