Individual provider Active NPI

Jennifer L Gannon, M.D.

  • Pediatrics Physician
  • Overland Park, KS
National Provider Identifier
1740218270
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
04-37711 Issued in KS
Practice address
5808 W 110TH St
Overland Park, KS 66211-2504
Phone
(913) 696-8000
NPI assigned
Jun 30, 2006
Last updated
Mar 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X 04-37711 KS
Clinical Genetics (M.D.) Physician 207SG0201X 2014044366 MO
Pediatrics Physician 208000000X 2014044366 MO
Pediatrics Physician 208000000X 04-37711 KS Primary

Addresses

Primary practice location

5808 W 110TH St
Overland Park, KS 66211-2504

Mailing address

2401 Gillham Rd
Attn Provider Enrollment Dept
Kansas City, MO 64108-4619
Phone (816) 701-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150122000504 MO Practitioner - Pediatric Medicine 4183622244 Reassigns benefits to 1 organization
I20150122001345 KS Practitioner - Pediatric Medicine 4183622244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Connecticut School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Childrens Mercy HospitalGroup PAC ID 2466366026, 143 clinicians

Practice addresses (Care Compare)

2401 Gillham Rd
Kansas City, MO 64108-4619
Phone (816) 234-3000

5808 W 110TH St
Overland Park, KS 66211-2504
Phone (913) 696-8000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-37711KSMDPediatrics Physician
2014044366MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Children's Mercy Hospital CurrentSince Jan 6, 2015 Accepting new patients
The Children's Mercy Hospital Pediatrics CurrentSince Jan 6, 2015 Accepting new patients
The Children's Mercy Hospital Past Accepting new patients

Locations

5808 W 110th St
Overland Park, KS 66211
Phone (913) 696-8000

2401 Gillham Rd
Kansas City, MO 64108
Phone (816) 234-3380

Interoperability endpoints

  • Direct secure messaging: jgannon@direct.wtbyhosp.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1740218270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "address_2": "ATTN PROVIDER ENROLLMENT DEPT",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-701-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5808 W 110TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662112504",
            "telephone_number": "913-696-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "KS",
            "license": "04-37711",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "MO",
            "license": "2014044366",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2014044366",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "04-37711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.