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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACK FENNEL DO
NPI 1356300271
Family Medicine - Adult Medicine in Fort Leonard Wood, MO

Active since March 20, 2006
126 MISSOURI AVE, FORT LEONARD WOOD, MO 65473(573) 329-8305(573) 329-8302 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 13, 2026, Sep 11, 2025 (2 updates tracked since 2025).

About Jack Fennel Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK FENNEL DO (NPI 1356300271) is an individual adult medicine provider in Fort Leonard Wood, Missouri, licensed in Missouri (R9D28) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1356300271
Entity TypeIndividualMale
Primary Taxonomy207QA0505X
Provider Legal NameJACK FENNELCredential: DO
Location Address126 MISSOURI AVEFort Leonard Wood, MO 65473-8952
Mailing Address126 Missouri AveFort Leonard Wood, MO 65473-8952 · (573) 329-8305 · Fax (573) 329-8302
Phone(573) 329-8305
Fax(573) 329-8302
Sole ProprietorNo
Enumeration DateMarch 20, 2006
Last NPPES UpdateJuly 13, 20262 updates tracked since enumeration
✔ NPI 1356300271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
License✔ Licensed in MO · R9D28
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
Also ListedFamily MedicineTaxonomy 207Q00000X · License R9D28 (MO)
126 MISSOURI AVE, Fort Leonard Wood, MO 65473
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BRENDAN DAUGHARTY GRIFFIS DO
Anesthesiology
126 MISSOURI AVE
FORT LEONARD WOOD, MO 65473
Pulaski County (573) 596-0471
VICTORIA ANNE GRUBE
Specialist/Technologist, Pathology (Immunology)
126 MISSOURI AVE
FORT LEONARD WOOD, MO 65473
Pulaski County (573) 596-1682
SHANNON RAE MATHERLY CRT
Respiratory Therapist, Certified
126 MISSOURI AVE
FORT LEONARD WOOD, MO 65473
Pulaski County (573) 596-0131
NICHOLAS DOBBS
Physical Therapy Assistant
126 MISSOURI AVE
FORT LEONARD WOOD, MO 65473
Pulaski County (573) 596-1707
MRS. SHAUNIA ROBERTS LPN
Licensed Practical Nurse
126 MISSOURI AVE
FORT LEONARD WOOD, MO 65473
Pulaski County (573) 596-1766
DEBBIE JEAN ROBERTS
Specialist/Technologist (Audiology Assistant)
126 MISSOURI AVE
FORT LEONARD WOOD, MO 65473
Pulaski County (573) 596-0131
MRS. KATHY LYNN MULLIHAN
Registered Nurse (Emergency)
126 MISSOURI AVE
FT. LEONARD WOOD, MO 65473
Pulaski County (573) 596-0456
RICKEY RODGER MARTIN PA
Physician Assistant (Medical)
126 MISSOURI AVE
FORT LEONARD WOOD, MO 65473
Pulaski County (573) 596-0417

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Fennel's NPI number?

The NPI number for Jack Fennel is 1356300271. It was assigned to this individual provider in the NPPES registry on March 20, 2006.

Where is Jack Fennel located?

Jack Fennel practices at 126 Missouri Ave, Fort Leonard Wood, MO 65473. The listed phone number is (573) 329-8305.

What is Jack Fennel's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

When was this NPI record last updated?

The NPPES record for Jack Fennel was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 31 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.