Individual provider Active NPI

Jamie Kay Woodall, LAT

  • Athletic Trainer
  • College Station, TX
National Provider Identifier
1508957135
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT2961 Issued in TX
Practice address
2118 Welsh Ave
College Station, TX 77840-4867
Phone
(979) 764-5536
Fax
(979) 764-5528
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT2961 TX Primary

Addresses

Primary practice location

2118 Welsh Ave
College Station, TX 77840-4867

Mailing address

1413 Front Royal Dr
College Station, TX 77845-4003
Phone (682) 651-9028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AT2961TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508957135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 FRONT ROYAL DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778454003",
            "telephone_number": "682-651-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 WELSH AVE",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778404867",
            "telephone_number": "979-764-5536",
            "fax_number": "979-764-5528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODALL",
        "first_name": "JAMIE",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT2961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.