Keith Austin Wommack, C.S.B.

Primary specialty

Religious Nonmedical PractitionerTaxonomy code 374K00000X

Practice address

514 Ronson Dr
Corpus Christi, TX 78412-3152

Phone

(361) 992-2487

Fax

(361) 991-6310

NPI assigned

Feb 17, 2012

Last updated

Feb 17, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1235402447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 RONSON DR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784123152",
            "telephone_number": "361-992-2487",
            "fax_number": "361-991-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 RONSON DR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784123152",
            "telephone_number": "361-992-2487",
            "fax_number": "361-991-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOMMACK",
        "first_name": "KEITH",
        "middle_name": "AUSTIN",
        "name_prefix": "Mr.",
        "credential": "C.S.B.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-17",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374K00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirley Lorraine Wolbrink, MS, LPC, LMFT
• Donna Lynn Wolf Robichaud, LPC
• Kimberly Wolford
• Women's and Men's Health Services of the Coastal Bend, Inc.
• Women's and Men's Health Services of the Coastal Bend, Inc.
• Douglas Wondra
• Kevin Kwockyau Wong Jr., LPC-ASSOCIATE
• Matthew Ngai-Heung Wong, PT
• Amy Wood, CRNA
• Matthew Wood

• Religious Nonmedical Practitioner in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Religious Nonmedical Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.