Van Treece Woodall, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000029947 Issued in MS

Practice address

1325 E Fortification St
Jackson, MS 39202-2442

Phone

(601) 354-4488

NPI assigned

Jul 25, 2017

Last updated

Jul 25, 2017By the provider in NPPES

Sex

Female

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

State licenses

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500940800000",
    "number": "1700309374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 ROBB ST",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "396667167",
            "telephone_number": "601-248-9676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E FORTIFICATION ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022442",
            "telephone_number": "601-354-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODALL",
        "first_name": "VAN TREECE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2017-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MS",
            "license": "2000029947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Wood, LPC
• Megan E Wood, OTR/L
• Mia Caroline Wood, AGACNP
• Bonnie N. Woodall, M.D.
• James William Woodall Jr., M.D.
• Alexisa Woodard
• Mattie Woodberry
• Chianti Woodfork, D.D.S.
• Daniel Morse Woodliff, M.D.
• Jill M Woodliff, MD

• Athletic Trainer in Jackson, MS
• Providers in Jackson, MS by specialty
• Athletic Trainer in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2017; 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.