Kenneth A Woodard Jr., MS,LAT,ATC,PES,CES

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT6526 Issued in TX

Practice address

211 Redbird LN
Beaumont, TX 77705-9801

Phone

(409) 880-7394

Fax

(409) 880-2366

NPI assigned

Jul 3, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Credentials

Master of Science

State licenses

Practice roles

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.

• Lamar University

  dba Lamar Speech & Hearing

  • Audiologist
  • Beaumont, TX
  • NPI 1669490389
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1639108236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 REDBIRD LN",
            "address_2": "CAMPUS BOX 10611/ATHLETIC TRAINING",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777059801",
            "telephone_number": "409-880-7394",
            "fax_number": "409-880-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 REDBIRD LN",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777059801",
            "telephone_number": "409-880-7394",
            "fax_number": "409-880-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MS,LAT,ATC,PES,CES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT6526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Winnie-Stowell Hospital District (Spindletop Hill Nursing and Rehabilitation Center)
• Winnie-Stowell Hospital District (Beaumont Health Care Center)
• Wise & Rooted Counseling and Therapy
• Wise Faith Counseling, PLLC
• James Francis Wood
• Amber Marcia Woods, LPC
• Jacie Woodson
• Connie Wooley, LVN
• Karen Delcid Woosley, APRN
• Eric Tyler Wooten, D.O.

• Athletic Trainer in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.