ABUNDANT HEALTH MEDICAL CLINIC, LLC (NPI# 1003288614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003288614 |
| Entity Type | Organization |
| Organization Name | ABUNDANT HEALTH MEDICAL CLINIC, LLC |
| Other Organization Name | ABUNDANT HEALTH MEDICAL CLINIC |
| Practice Address |
1001 Jackson St Thibodaux LA 70301-3227 |
| Mailing Address |
Po Box 5011 Thibodaux LA 70302-5011 |
| Practice Telephone | 9854929111 |
| Practice Fax Number | 9854929114 |
| Mailing Telephone | 9854929111 |
| Mailing Fax Number | 9854929114 |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2015-10-22 |
| Authorized Official Name | DR. ADRIENNE CHANELLE ROBERTSON (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3342942758 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2371231. | 05 |
| Other Name | Type Code |
|---|---|
| Abundant Health Medical Clinic | Doing Business As Name - Organization |
| Street Address |
1001 JACKSON ST |
| City | THIBODAUX |
| State | LA |
| Zip Code | 70301-3227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871792051 | Adrienne C Robertson | Family Medicine | 1001 Jackson St, Thibodaux, LA 70301-3227 | 2007-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225539620 | Micah Aaron Callais | Nurse Practitioner | 604 N. Acadia Road, Suite 200, Thibodaux, LA 70301 | 2018-02-22 |
| 1982112348 | Katie Leblanc | Massage Therapist | 1115 St. Mary Street, Thibodaux, LA 70301 | 2018-01-18 |
| 1154837391 | Texas Digestive Disease Consultants, Pllc | Internal Medicine | 764 North Acadia Road, Suite A, Thibodaux, LA 70301 | 2017-12-26 |
| 1235648239 | Speech and Feeding Therapy, LLC | Speech-Language Pathologist | 1000 Plantation Rd Ste 1a, Thibodaux, LA 70301 | 2017-09-22 |
| 1285150466 | Tara Payne | Counselor | 303 Hickory Street, Thibodaux, LA 70301 | 2017-08-18 |
| 1427583475 | Tyler Pettigrew | Counselor | 300 Plantation Rd., Apt #24, Thibodaux, LA 70301 | 2017-04-27 |
| 1750825758 | Jessica Barquet | Counselor | 110 Palm Villa Dr Apt 1, Thibodaux, LA 70301 | 2016-12-09 |
| 1013468230 | Shenee Haas Gros | Counselor | 504 Cherry St., Thibodaux, LA 70301 | 2016-10-24 |
| 1982155388 | Southern Ent Associates Inc | Audiologist | 604 North Acadia Road Suite 101, Thibodaux, LA 70301 | 2016-10-20 |
| 1215483888 | Lesheeca Norman, Lpc | Counselor | 306 Victoria Court, Thibodaux, LA 70301 | 2016-09-01 |
| Find all providers in zip 70301 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902966492 | Quentin D. Falgoust Md A Medical Corporation | Clinic/Center | 1101 Audubon Ave Ste N5, Thibodaux, LA 70301-4957 | 2006-12-12 |
| 1508082173 | Preferred Pediatrics | Clinic/Center | 200 E 6th St, Thibodaux, LA 70301-3426 | 2007-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193593 | L & F Ross Transportation, LLC | Clinic/Center | 2645 Taffy Dr, Marrero, LA 70072-5745 | 2020-04-21 |
| 1649709452 | Guste Plastic and Reconstructive Surgery, LLC | Clinic/Center | 3900 Veterans Blvd., Suite 200, Metairie, LA 70002 | 2017-06-06 |
| 1508227604 | Acadiana Allergy, Asthma and Immunology Center, LLC | Clinic/Center | 300 Rue Beauregard Ste F, Lafayette, LA 70508 | 2016-03-16 |
| 1215398631 | Stonewall Eye Care | Clinic/Center | 2434 Highway 171, Stonewall, LA 71078-9420 | 2016-03-11 |
| 1306273511 | Va Culotta Jr Md LLC | Clinic/Center | 4420 Conlin St., Ste 300, Metairie, LA 70006 | 2013-10-02 |
| 1306109350 | Active Spine Care LLC | Clinic/Center | 8108 Picardy Ave Ste E, Baton Rouge, LA 70809-3514 | 2012-06-22 |
| 1003183047 | Clear Imaging LLC | Clinic/Center | 1241a 7th St, Slidell, LA 70458-2041 | 2011-11-18 |
| 1295064004 | Cynthia A. Williams, A.p.m.c. | Clinic/Center | 3555 Loyola Dr, Kenner, LA 70065-7706 | 2009-12-08 |
| 1205075256 | Peter Hertzak M.d. Pmc | Clinic/Center | 985 Robert Blvd Ste 102, Slidell, LA 70458-2063 | 2009-02-16 |
| 1215191903 | Myriam D Hutchinson Md | Clinic/Center | 104 N. Hospital Dr., Abbeville, LA 70510-4039 | 2008-07-11 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ABUNDANT HEALTH MEDICAL CLINIC, LLC.
| 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.