MISS KELLEY LUCILLE WEIDINGER


Address: 3308 W Edgewood Dr Ste F, Jefferson City, MO 65109-6891
Phone: 5736383400

MISS KELLEY LUCILLE WEIDINGER (NPI# 1093910812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1093910812
Entity Type Individual
Full Name MISS KELLEY LUCILLE WEIDINGER
Credential ATC, LAT
Practice Address 3308 W Edgewood Dr Ste F
Jefferson City
MO 65109-6891
Mailing Address 11820 Maries Road 328
Vienna
MO 65582-7123
Practice Telephone 5736383400
Practice Fax Number 5736383405
Mailing Telephone 5736803826
Enumeration Date 2007-06-20
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2255A2300X Specialist/Technologist
Specialization: Athletic Trainer
2007017252 MO Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Office Location

Street Address 3308 W EDGEWOOD DR STE F
City JEFFERSON CITY
State MO
Zip Code 65109-6891

Providers in the same location

NPI Name Taxonomy Address Enumeration
1396149217 Spenser Deeken Specialist/Technologist 3308 W Edgewood Dr Ste F, Jefferson City, MO 65109-6891 2014-10-21

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518449321 Kara D Roderick Physical Therapist 1115 Fairgrounds Road, Jefferson City, MO 65109 2018-08-29
1851871214 Integrative Medicine, LLC Internal Medicine 999 Diamond Rdg Ste 201, Jefferson City, MO 65109 2018-08-15
1972020394 Rehab Care Group East, LLC Clinic/Center Primrose Retirement Community Jefferson City, 1214 Freedom Boulevard, Jefferson City, MO 65109 2017-08-25
1124558986 Nicholas Rehagen Specialist/Technologist 304 Timber Creek Rd, Jefferson City, MO 65109 2017-06-14
1982004214 Kara Elizabeth Wilbers Occupational Therapist 1105 Fairgrounds Rd, Jefferson City, MO 65109 2014-08-22
1942510334 Loftin Eyecare, LLC Optometrist 724 West Stadium Boulevard, # 029 Walmart Vision Center, Jefferson City, MO 65109 2010-10-19
1306077250 Paula Hancock Johnson Social Worker 1303 Edgewood Dr Ste 5, Jefferson City, MO 65109 2009-07-27
1679701296 Capital Region Medical Center Family Medicine 3308 W Edgewood, Suite B, Jefferson City, MO 65109 2009-06-23
1972730141 Nancy S Stork Counselor 204 Metro, Suite B, Jefferson City, MO 65109 2009-06-16
1356522916 Walk Easy LLC Durable Medical Equipment & Medical Supplies 4810 Rainbow Dr., Jefferson City, MO 65109 2007-11-23
Find all providers in zip 65109

Taxonomy Information

Taxonomy Code 2255A2300X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Specialist/Technologist
Specialization Athletic Trainer

Taxonomy Definition

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.
Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1669931267 Kaitlyn Elizabeth Burkemper Specialist/Technologist 3830 Oxford Rd, Jefferson City, MO 65109-5341 2019-03-14
1124558986 Nicholas Rehagen Specialist/Technologist 304 Timber Creek Rd, Jefferson City, MO 65109 2017-06-14
1003236506 Austin Matlock Specialist/Technologist 820 Chestnut St, 115 Jason Hall, Jefferson City, MO 65101-3537 2014-04-23
1134485634 Travis Arvin Stueve Specialist/Technologist 904 E Mountcastle St, Jefferson City, TN 37760-2607 2012-04-09
1043465446 Shawn C Dumers Specialist/Technologist 4704 Woods Xing, Jefferson City, MO 65109-6221 2008-11-26
1881728095 Kay Lea Foster Specialist/Technologist 3221 Glenstone Dr, Jefferson City, MO 65109-8801 2007-03-16
1477577500 Thomas M Brundage Specialist/Technologist 1002 Diamond Rdg Ste 800, Jefferson City, MO 65109-7906 2006-07-26
1760426910 Ronald Joseph Dunn Specialist/Technologist 1305 Swifts Hwy, Jefferson City, MO 65109-2557 2006-06-16
1326001207 Misty Depriest Hudgins Specialist/Technologist 2130 S Branner Avenue, Cn Box 72030 -, Jefferson City, TN 37760 2006-04-11
1063485852 Michael Todd Vanbruggen Specialist/Technologist 2130 S Branner Ave, Cn Box 72030, Jefferson City, TN 37760-2224 2006-02-10
Find all providers in JEFFERSON CITY

Competitor

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City JEFFERSON CITY
Zip Code 65109

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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