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).
| 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 |
| 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 |
| Street Address |
3308 W EDGEWOOD DR STE F |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65109-6891 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396149217 | Spenser Deeken | Specialist/Technologist | 3308 W Edgewood Dr Ste F, Jefferson City, MO 65109-6891 | 2014-10-21 |
| 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 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 |
|---|---|---|---|---|
| 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 | ||||
| City | JEFFERSON CITY |
| Zip Code | 65109 |
Please comment or provide details below to improve the information on MISS KELLEY LUCILLE WEIDINGER.
| 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.