Individual provider Active NPI

Joshua Charles Yonker, MS, LAT, ATC

  • Athletic Trainer
  • Beaumont, TX
National Provider Identifier
1659307379
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT3457 Issued in TX
Practice address
4400 S. MLK Jr Pkwy
Lamar Univ. Dauphin Athletic Complex
Beaumont, TX 77705
Phone
(409) 880-2359
Fax
(409) 880-2366
NPI assigned
Jun 24, 2006
Reactivated
Jun 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 AT3457 TX Primary

Addresses

Primary practice location

4400 S. MLK Jr Pkwy
Lamar Univ. Dauphin Athletic Complex
Beaumont, TX 77705

Mailing address

211 Red Bird Lane
Campus Box 10611
Beaumont, TX 77710
Phone (409) 880-2359

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
AT3457TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659307379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 RED BIRD LANE",
            "address_2": "CAMPUS BOX 10611",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77710",
            "telephone_number": "409-880-2359",
            "fax_number": "409-880-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 S. MLK JR PKWY",
            "address_2": "LAMAR UNIV. DAUPHIN ATHLETIC COMPLEX",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77705",
            "telephone_number": "409-880-2359",
            "fax_number": "409-880-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YONKER",
        "first_name": "JOSHUA",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2022-07-21",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2017-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT3457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • 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.