MR. KENNETH A WOODARD JR. (NPI# 1639108236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639108236 |
| Entity Type | Individual |
| Full Name | MR. KENNETH A WOODARD JR. |
| Credential | MS,LAT,ATC,PES,CES |
| Practice Address |
211 Redbird Ln Beaumont TX 77705-9801 |
| Mailing Address |
211 Redbird Ln Campus Box 10611/athletic Training Beaumont TX 77705-9801 |
| Practice Telephone | (409) 880-7394 |
| Practice Fax Number | 4098802366 |
| Mailing Telephone | (409) 880-7394 |
| Mailing Fax Number | 4098802366 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2017-05-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT6526 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
211 REDBIRD LN |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77705-9801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134737083 | Joseph Scott Ballard | Specialist/Technologist | 211 Redbird Ln, Beaumont, TX 77705-9801 | 2020-07-16 |
| 1619598471 | Tessa Jean Hughes | Dietitian, Registered | 211 Redbird Ln, Beaumont, TX 77705-9801 | 2020-05-04 |
| 1104380559 | Kiera Mattern | Specialist/Technologist | 211 Redbird Ln, Beaumont, TX 77705-9801 | 2019-01-29 |
| 1740754605 | Kendall Rene Brookins | Specialist/Technologist | 211 Redbird Ln, Beaumont, TX 77705-9801 | 2019-01-14 |
| 1942787023 | Raymond Leslie Burnett Iv | Specialist/Technologist | 211 Redbird Ln, Beaumont, TX 77705-9801 | 2018-07-23 |
| 1063922730 | Lamar University | Orthopaedic Surgery | 211 Redbird Ln, Beaumont, TX 77705-9801 | 2017-10-06 |
| 1760911770 | Dominic Joseph Gradozzi IIi | Specialist/Technologist | 211 Redbird Ln, Beaumont, TX 77705-9801 | 2017-06-05 |
| 1376071936 | Matthew S Preston | Specialist/Technologist | 211 Redbird Ln, Beaumont, TX 77705-9801 | 2017-05-26 |
| 1255869855 | Jessica Ringo | Specialist/Technologist | 211 Redbird Ln, Beaumont, TX 77705-9801 | 2017-05-25 |
| 1245768035 | Kathleen E Barker | Specialist/Technologist | 211 Redbird Ln, Beaumont, TX 77705-9801 | 2017-05-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801431390 | Iris Fiaui | Specialist/Technologist | 4400 Mlk Jr Pkwy, Beaumont, TX 77705 | 2019-11-08 |
| 1437644937 | Kolten Elizabeth Adams | Specialist/Technologist | 4400 S Mlk Jr Parkway, Beaumont, TX 77705 | 2018-06-27 |
| 1326443391 | Scott Forbes | Psychologist | 6200 Knauth Rd, Beaumont, TX 77705 | 2014-11-03 |
| 1518367622 | Dennis Agricola | Nurse Practitioner | 6200 Knauth Road, Beaumont, TX 77705 | 2014-08-26 |
| 1639591480 | Chs Texas Medical, P.a. | General Practice | 11357 Highway 10 Sw, Smith Rd, Beaumont, TX 77705 | 2014-01-14 |
| 1649523309 | Tri-medical Emergency Medical Services Lp | Ambulance | 4610 St. Louis St, Beaumont, TX 77705 | 2012-10-18 |
| 1437462785 | Cynthia Ksiazek | Social Worker | 857 E Virginia, Beaumont, TX 77705 | 2010-07-15 |
| 1457509424 | Gaurav Puri | Dentist | 4400 Highland Ave, Beaumont, TX 77705 | 2008-09-03 |
| 1588811731 | Prasad L Surapaneni | Family Medicine | 5430 Knauth Rd, Beaumont, TX 77705 | 2008-08-19 |
| 1891994612 | Jennifer Lien Truong | Occupational Therapist | 4205 Grandberry, Beaumont, TX 77705 | 2007-07-12 |
| Find all providers in zip 77705 | ||||
| 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 |
|---|---|---|---|---|
| 1801431390 | Iris Fiaui | Specialist/Technologist | 4400 Mlk Jr Pkwy, Beaumont, TX 77705 | 2019-11-08 |
| 1942765706 | Alexandra Susan Furey | Specialist/Technologist | 4040 Crow Rd Apt 119, Beaumont, TX 77706-7052 | 2019-02-06 |
| 1437644937 | Kolten Elizabeth Adams | Specialist/Technologist | 4400 S Mlk Jr Parkway, Beaumont, TX 77705 | 2018-06-27 |
| 1366968844 | Danae Tuhn | Specialist/Technologist | 3443 Fannett Rd, Beaumont, TX 77705-1322 | 2017-08-16 |
| 1013438209 | Jordan Corley | Specialist/Technologist | 1450 N Major Dr Apt 903, Beaumont, TX 77706-4077 | 2017-06-28 |
| 1497284319 | Emlyn Melilt Ngiratmab | Specialist/Technologist | 211 Redbird Ln # 10611, Beaumont, TX 77705-9801 | 2017-06-05 |
| 1659307379 | Joshua Charles Yonker | Specialist/Technologist | 4400 S. Mlk Jr Pkwy, Lamar Univ. Dauphin Athletic Complex, Beaumont, TX 77705 | 2006-06-24 |
| 1497799811 | Matthew M Lewis | Specialist/Technologist | 8420 Anastasia Ave, Beaumont, TX 77705-9423 | 2006-06-15 |
| 1639131428 | Jon Matthew Price | Specialist/Technologist | 4400 Martin Luther King Blvd, Athletic Training, Beaumont, TX 77707 | 2006-04-05 |
| 1134737083 | Joseph Scott Ballard | Specialist/Technologist | 211 Redbird Ln, Beaumont, TX 77705-9801 | 2020-07-16 |
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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.