THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION (NPI# 1306125133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306125133 |
| Entity Type | Organization |
| Organization Name | THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION |
| Other Organization Name | THIBODAUX REGIONAL INTERNAL MEDICINE CLINIC |
| Practice Address |
604 N Acadia Rd Ste 410 Thibodaux LA 70301-4897 |
| Mailing Address |
Po Box 5478 Thibodaux LA 70302-5478 |
| Practice Telephone | 9854934004 |
| Practice Fax Number | 9854934007 |
| Mailing Telephone | 9854354831 |
| Mailing Fax Number | 9854492585 |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2020-06-24 |
| Authorized Official Name | KIM LEGENDRE BOUDREAUX (CONTRACT MANAGER) |
| Authorized Official Telephone | 9854934907 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2403915 | 05 |
| Other Name | Type Code |
|---|---|
| Thibodaux Regional Internal Medicine Clinic | Doing Business As Name - Organization |
| Thibodaux Regional Network Development Corporation - Internal Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043836166 | Thibodaux Regional Network Development Corporation | Podiatrist | 726 N Acadia Rd Ste 1700, Thibodaux, LA 70301-5051 | 2020-06-24 |
| 1003430257 | Thibodaux Regional Network Development Corporation | Surgery | 604 N Acadia Rd Ste 410, Thibodaux, LA 70301-4897 | 2020-06-03 |
| 1396162269 | Thibodaux Regional Network Development Corporation | Family Medicine | 114 Hwy 403, Paincourtville, LA 70391-0300 | 2014-03-27 |
| 1184963613 | Thibodaux Regional Network Development Corporation | Obstetrics & Gynecology | 604 N Acadia Rd Ste 500, Thibodaux, LA 70301-4743 | 2013-02-04 |
| 1467427336 | Thibodaux Regional Network Development Corporation | Radiology | 602 N Acadia Rd, Thibodaux, LA 70301-4847 | 2006-02-22 |
| 1043834260 | Thibodaux Regional Network Development Corporation | Urology | 504 N Acadia Rd, Thibodaux, LA 70301-4862 | 2020-06-03 |
| 1437664646 | Thibodaux Regional Network Development Corporation | Pathology | 602 N Acadia Rd, Thibodaux, LA 70301-4823 | 2017-12-11 |
| 1447701412 | Thibodaux Regional Network Development Corporation | Internal Medicine | 602 N Acadia Rd, Thibodaux, LA 70301-4823 | 2016-10-14 |
| 1114339181 | Thibodaux Regional Network Development Corporation | Psychiatry & Neurology | 604 N Acadia Rd, Suite 410, Thibodaux, LA 70301-4897 | 2014-05-27 |
| 1215355128 | Thibodaux Regional Network Development Corporation | Internal Medicine | 726 N Acadia Rd, Ste 3300, Thibodaux, LA 70301-4847 | 2014-03-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION - RHEUMATOLOGY | 1105 Audubon Ave Ste B, Thibodaux, LA 70301-4940 |
| Street Address |
604 N ACADIA RD STE 410 |
| City | THIBODAUX |
| State | LA |
| Zip Code | 70301-4897 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588668826 | Kenneth James Cruse | Pediatrics | 604 N Acadia Rd, Suite 200, Thibodaux, LA 70301-4897 | 2005-06-01 |
| 1336686088 | Amy Brannon Anderson | Social Worker | 604 N Acadia Rd, Suite 201, Thibodaux, LA 70301-4897 | 2017-01-19 |
| 1114339181 | Thibodaux Regional Network Development Corporation | Psychiatry & Neurology | 604 N Acadia Rd, Suite 410, Thibodaux, LA 70301-4897 | 2014-05-27 |
| 1891118576 | Dean Francis Click Jr. | Specialist/Technologist, Other | 604 N Acadia Rd, Ste 508, Thibodaux, LA 70301-4897 | 2014-01-30 |
| 1801136023 | Thibodaux Regional Network Development Corporation | Internal Medicine | 604 N Acadia Rd, Suite 411, Thibodaux, LA 70301-4897 | 2013-02-25 |
| 1164770418 | April D Sorrel | Pediatrics | 604 N Acadia Rd, Suite 200, Thibodaux, LA 70301-4897 | 2012-08-16 |
| 1215214366 | Cowen Clinic for Rehabilitation Medicine, Apmc | Specialist | 604 N Acadia Rd, Suite 100, Thibodaux, LA 70301-4897 | 2011-11-03 |
| 1366754160 | Kim R Thompson | Social Worker | 604 N Acadia Rd, Suite 201, Thibodaux, LA 70301-4897 | 2010-07-08 |
| 1679896732 | Bariatric & Advanced Surgical | Surgery | 604 N Acadia Rd, Suite 406, Thibodaux, LA 70301-4897 | 2010-03-03 |
| 1669606646 | John C Hildenbrand Iv LLC | Orthopaedic Surgery | 604 N Acadia Rd, Suite 508, Thibodaux, LA 70301-4897 | 2009-05-06 |
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| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972895886 | Beau David Boudreaux | Internal Medicine | 726 N Acadia Rd Ste 3400, Thibodaux, LA 70301-5009 | 2011-05-10 |
| 1699792564 | Gayathri Talluri | Internal Medicine | 931 North Canal Blvd, Thibodaux, LA 70301 | 2006-07-16 |
| 1720686785 | Jame T Soignet M D L L C | Internal Medicine | 142 Rue Marguerite Ste B, Thibodaux, LA 70301-6708 | 2020-10-13 |
| 1073157970 | Life Coast Community Health Center Inc | Internal Medicine | 1101 Audubon Ave Ste S1, Thibodaux, LA 70301-4957 | 2019-11-04 |
| 1669996658 | Sunanda Kotapuri | Internal Medicine | 931 N Canal Blvd, Thibodaux, LA 70301-8095 | 2017-08-01 |
| 1669913943 | Devin Michael Bourgeois | Internal Medicine | 506 N Acadia Rd, Thibodaux, LA 70301-4862 | 2017-03-20 |
| 1851833396 | Chester G Boudreaux Md Inc | Internal Medicine | 142 Rue Marguerite, Thibodaux, LA 70301-6708 | 2016-11-15 |
| 1447701412 | Thibodaux Regional Network Development Corporation | Internal Medicine | 602 N Acadia Rd, Thibodaux, LA 70301-4823 | 2016-10-14 |
| 1144607151 | Seth Guidry | Internal Medicine | 602 N Acadia Rd, Thibodaux, LA 70301-4823 | 2015-04-28 |
| 1891114310 | Amrita Singh | Internal Medicine | 931 North Canal Blvd, Thibodaux, LA 70301 | 2014-04-11 |
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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.