Individual provider Active NPI

Jennifer Leah Carollo, WHNP

  • Women's Health Nurse Practitioner
  • Lee's Summit, MO
National Provider Identifier
1760282131
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
2025008123 Issued in MO
Practice address
120 NE Saint Lukes Blvd FL 3
Lees Summit, MO 64086-1000
Phone
(816) 251-5780
Fax
(816) 251-5781
NPI assigned
Mar 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2017003020 MO
Women's Health Nurse Practitioner 363LW0102X 2025008123 MO Primary

Addresses

Primary practice location

120 NE Saint Lukes Blvd FL 3
Lees Summit, MO 64086-1000

Mailing address

120 NE Saint Lukes Blvd FL 3
Lees Summit, MO 64086-1000
Phone (816) 251-5780

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250805000600 MO Practitioner - Nurse Practitioner 9032627690 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

120 NE Saint Luke's Blvd
3Rd FL
Lee's Summit, MO 64063-6000
Phone (816) 251-5780

825 Euclid Ave
Kansas City, MO 64124-2323
Phone (816) 474-4920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2017003020MOMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel U. Rodgers Health Center, Inc CurrentSince Jul 21, 2025 Accepting new patients
Samuel U. Rodgers Health Center, Inc. CurrentSince Jul 21, 2025 Accepting new patients
Saint Luke's Physician Group Inc PastSince Jun 15, 2026 Accepting new patients

Locations

825 Euclid Ave
Kansas City, MO 64124
Phone (816) 889-4816

5330 N Oak Trfy
Ste 104
Kansas City, MO 64118
Phone (816) 455-7471

Interoperability endpoints

  • Direct secure messaging: jennifer.carollo.p1@direct.rodgershealth.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1741996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1760282131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 NE SAINT LUKES BLVD FL 3",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640861000",
            "telephone_number": "816-251-5780",
            "fax_number": "816-251-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 NE SAINT LUKES BLVD FL 3",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640861000",
            "telephone_number": "816-251-5780",
            "fax_number": "816-251-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAROLLO",
        "first_name": "JENNIFER",
        "middle_name": "LEAH",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-15",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2017003020",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MO",
            "license": "2025008123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.