Individual provider Active NPI

Richey E. Woods, ATC

  • Athletic Trainer
  • Jackson, MS
National Provider Identifier
1881602167
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0011 Issued in MS
Practice address
1325 E Fortification St
Jackson, MS 39202-2442
Phone
(601) 354-4488
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
Yes

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 0011 MS Primary

Addresses

Primary practice location

1325 E Fortification St
Jackson, MS 39202-2442

Mailing address

1397 Litton Rd
Shaw, MS 38773-9560
Phone (662) 721-3349

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
0011MSMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881602167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1397 LITTON RD",
            "city": "SHAW",
            "state": "MS",
            "postal_code": "387739560",
            "telephone_number": "662-721-3349",
            "fax_number": "662-754-2233"
        },
        {
            "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": "WOODS",
        "first_name": "RICHEY",
        "middle_name": "E.",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MS",
            "license": "0011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

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.