VAN TREECE WOODALL


Address: 1325 E Fortification St, Jackson, MS 39202-2442
Phone: 6013544488

VAN TREECE WOODALL (NPI# 1700309374) 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) 1700309374
Entity Type Individual
Full Name VAN TREECE WOODALL
Credential ATC
Practice Address 1325 E Fortification St
Jackson
MS 39202-2442
Mailing Address 304 Robb St
Summit
MS 39666-7167
Practice Telephone 6013544488
Mailing Telephone 6012489676
Enumeration Date 2017-07-25
Last Update Date 2017-07-25
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
2000029947 MS Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Office Location

Street Address 1325 E FORTIFICATION ST
City JACKSON
State MS
Zip Code 39202-2442

Providers in the same location

NPI Name Taxonomy Address Enumeration
1386632560 Chris Phillip Ethridge Orthopaedic Surgery 1325 E Fortification St, Jackson, MS 39202-2442 2005-10-11
1144832130 Georgiana Ogletree Occupational Therapist 1325 E Fortification St, Jackson, MS 39202-2442 2020-08-20
1972133353 Justin Bryant Schopp Physician Assistant 1325 E Fortification St, Jackson, MS 39202-2442 2020-01-24
1154951739 Hailey Daniels Kelly Physician Assistant 1325 E Fortification St, Jackson, MS 39202-2442 2020-01-22
1356903520 James Logan Ferrell Occupational Therapist 1325 E Fortification St, Jackson, MS 39202-2442 2019-07-08
1184185472 Jamie Jackson Garrett Physician Assistant 1325 E Fortification St, Jackson, MS 39202-2442 2019-03-28
1114494754 Charles Taylor Knapp Nurse Practitioner 1325 E Fortification St, Jackson, MS 39202-2442 2018-11-01
1477078277 Leah Winstead West Physical Medicine & Rehabilitation 1325 E Fortification St, Jackson, MS 39202-2442 2017-08-14
1346760220 Megan Wallace Tyson Nurse Practitioner 1325 E Fortification St, Jackson, MS 39202-2442 2017-06-22
1083149181 John Causey Registered Nurse 1325 E Fortification St, Jackson, MS 39202-2442 2017-04-26
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982234183 Eva Mackenzie Carmody Physician Assistant 1190 N State St Suite 502, Jackson, MS 39202 2020-01-16
1750868691 Katherine Walters Nurse Practitioner 501 Marshall St., Suite 400, Jackson, MS 39202 2018-07-24
1932638749 Tylan Lee Social Worker 860 East River Place Suite 100, Jackson, MS 39202 2017-06-06
1417314725 Euna Jyles Counselor 860 E River Pl, Jackson, MS 39202 2016-01-19
1255712048 Edward Jonathan Breight Specialist/Technologist 1325 East Fortication Street, Jackson, MS 39202 2015-06-17
1881037703 Kara Spinks Logan Surgery 1190 N State St Ste 502, Jackson, MS 39202 2013-04-10
1477876530 Mick Inc. Technician 334 Josanna Street, Suite #209, Jackson, MS 39202 2010-03-03
1073724910 Paul Frederic Dare Anesthesiology 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 2007-05-24
1225247703 Lynn Kincannon Holland Counselor 911 Manship Street, Unit A, Jackson, MS 39202 2007-05-22
1457568149 Incare Inc Pulmonary Function Technologist 1151 North State St, Suite 406, Jackson, MS 39202 2007-05-16
Find all providers in zip 39202

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
1205471752 Shelly Ann Botwinick Specialist/Technologist 104 Daisy Ct, Jackson, NJ 08527-2582 2019-11-07
1023668019 Jonathan Wilson Specialist/Technologist 1050 Union University Dr # 1811, Jackson, TN 38305-3656 2019-09-12
1588132161 John Thomas Raybon Specialist/Technologist 328 Portis Ave, Jackson, AL 36545-2650 2018-11-13
1265925044 Caroline Marie Stevens Specialist/Technologist 715 S Grinnell St, Jackson, MI 49203-1685 2018-06-07
1447762067 Sarah Elisabeth Wilhelm Specialist/Technologist 3483 Spring Arbor Rd, Jackson, MI 49203-3637 2017-11-05
1619410388 Erin Nelson Specialist/Technologist 4174 Lancashire Dr, Jackson, MI 49203-5137 2016-11-29
1235681685 Latesha Fleming Specialist/Technologist 241 Glenside Dr, Jackson, MS 39211-4309 2016-11-02
1962855239 David Miller Specialist/Technologist 917 Bellevue Pl, Jackson, MS 39202-2702 2016-07-21
1023488186 Melanie J Weesies Specialist/Technologist 3417 Mayapple Ln Apt 32, Jackson, MI 49201-7199 2015-10-01
1255712048 Edward Jonathan Breight Specialist/Technologist 1325 East Fortication Street, Jackson, MS 39202 2015-06-17
Find all providers in JACKSON

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City JACKSON
Zip Code 39202

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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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