MR. EDMESTON ADOLPHUS WOODLEY II (NPI# 1518168236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518168236 |
| Entity Type | Individual |
| Full Name | MR. EDMESTON ADOLPHUS WOODLEY II |
| Credential | ATC, LAT |
| Practice Address |
118 College Dr # 5017 Hattiesburg MS 39406-0001 |
| Mailing Address |
309 Lake Ave Pueblo CO 81004-2329 |
| Practice Telephone | 6012666666 |
| Mailing Telephone | 7199240168 |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT0426 | MS | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
118 COLLEGE DR # 5017 |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39406-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295389633 | Jessica Amoruso | Specialist/Technologist | 118 College Dr # 5017, Hattiesburg, MS 39406-0002 | 2019-07-24 |
| 1023595220 | Natasha Hansen | Dietitian, Registered | 118 College Dr # 5017, Hattiesburg, MS 39406-0001 | 2018-07-20 |
| 1740792951 | Joshua Walker | Specialist/Technologist | 118 College Dr # 5017, Hattiesburg, MS 39406-0002 | 2017-10-27 |
| 1508378886 | Yuji Katsuta | Specialist/Technologist | 118 College Dr # 5017, Hattiesburg, MS 39406-0002 | 2017-10-26 |
| 1801316187 | Heather Nosky | Specialist/Technologist | 118 College Dr # 5017, Hattiesburg, MS 39406-0002 | 2017-06-27 |
| 1588198550 | Joseph Todd Mccall | Specialist/Technologist | 118 College Dr # 5017, Hattiesburg, MS 39406-0002 | 2017-04-17 |
| 1790227973 | Jayme Nauman | Specialist/Technologist | 118 College Dr # 5017, Hattiesburg, MS 39406-0002 | 2016-11-05 |
| 1093267304 | Melissa Chastang | Specialist/Technologist | 118 College Dr # 5017, Hattiesburg, MS 39406-0002 | 2016-11-03 |
| 1386190056 | Sven Pearson | Specialist/Technologist | 118 College Dr # 5017, Hattiesburg, MS 39406-0002 | 2016-08-31 |
| 1083038590 | Christopher Clapton | Specialist/Technologist | 118 College Dr # 5017, Hattiesburg, MS 39406 | 2014-02-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427559731 | Regan Ashley Nicholson I | Specialist/Technologist | 118 College Dr., Hattiesburg, MS 39406 | 2018-02-22 |
| 1407992233 | Katherine White | Nurse Practitioner | 118 College Dr, #5066, Hattiesburg, MS 39406 | 2007-01-29 |
| 1689710410 | Jacqueline Anne Wiebe | Psychiatry & Neurology | 118 College Dr, 5066, Hattiesburg, MS 39406 | 2007-01-29 |
| 1982740718 | Bennett E Smith Jr. | General Practice | 118 College Dr, 5066, Hattiesburg, MS 39406 | 2007-01-29 |
| 1396225025 | Leslie Oglesby | Specialist/Technologist | 118 College Dr # 5122, Hattiesburg, MS 39406-0001 | 2018-08-21 |
| 1689033268 | Chandra Nicole Strange | Psychologist | 118 College Dr # 5025, Hattiesburg, MS 39406-0001 | 2016-02-11 |
| 1710359922 | Chantel Nicole Chatham | Dietitian, Registered | 118 College Dr # 5114, Hattiesburg, MS 39406-0001 | 2015-10-27 |
| 1700272432 | Southern Miss Autism Research Team (smart) Clinic | Behavioral Analyst | 118 College Dr Box 5025, University of Southern Mississippi, Hattiesburg, MS 39406-0001 | 2015-04-09 |
| 1659781474 | Stephen Craig English Jr. | Physician Assistant | 118 College Dr Box 5066, Hattiesburg, MS 39406-0001 | 2014-05-01 |
| 1215273032 | University of Southern Mississippi | Speech-Language Pathologist | 118 College Dr Box 5215, Hattiesburg, MS 39406-0001 | 2012-12-26 |
| Find all providers in zip 39406 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942817895 | Thaxton Sullivan | Specialist/Technologist | 3 Courtland Dr Apt 50, Hattiesburg, MS 39402-8186 | 2020-09-24 |
| 1396225025 | Leslie Oglesby | Specialist/Technologist | 118 College Dr # 5122, Hattiesburg, MS 39406-0001 | 2018-08-21 |
| 1629556907 | Samuel Trent Morris | Specialist/Technologist | 221 Pine Ln, Hattiesburg, MS 39402-9213 | 2018-07-30 |
| 1154809457 | Alexandra C Flint | Specialist/Technologist | 12 Park Pl Apt 188f, Hattiesburg, MS 39402-1481 | 2018-07-30 |
| 1588152029 | Zachary Russell Walker | Specialist/Technologist | 820 Johnson Ave, Hattiesburg, MS 39402-2721 | 2018-04-30 |
| 1427559731 | Regan Ashley Nicholson I | Specialist/Technologist | 118 College Dr., Hattiesburg, MS 39406 | 2018-02-22 |
| 1154838183 | Amanda Mcbride | Specialist/Technologist | 25 Dunleith Ct, Hattiesburg, MS 39402-8866 | 2017-12-29 |
| 1477065779 | Evan Denoux | Specialist/Technologist | 216 Westover Dr Apt 17d, Hattiesburg, MS 39402-1375 | 2017-10-26 |
| 1326560319 | Shanickwa Jackson | Specialist/Technologist | 7 Lakewood Dr, Hattiesburg, MS 39402-9425 | 2017-07-11 |
| 1619406196 | Courtney Nicole Dossett | Specialist/Technologist | 807 Pineview Dr, Hattiesburg, MS 39401-7460 | 2017-06-08 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39406 |
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| 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.