MR. PATRICK ROLAND THIBEAULT (NPI# 1437392834) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437392834 |
| Entity Type | Individual |
| Full Name | MR. PATRICK ROLAND THIBEAULT |
| Practice Address |
14018 S Annapolis Ct Cedar Lake IN 46303-7283 |
| Practice Telephone | 2197659141 |
| Mailing Telephone | 2197659141 |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2013-05-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 28143935A | IN | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71002960A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
14018 S ANNAPOLIS CT |
| City | CEDAR LAKE |
| State | IN |
| Zip Code | 46303-7283 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356745327 | Robert Petersen | Occupational Therapy Assistant | 7105 W. 138th Ave., Cedar Lake, IN 46303 | 2014-10-20 |
| 1982956017 | Jean Marie Decavitch | Nurse Practitioner | 6831 W 133rd Ave, Cedar Lake, IN 46303 | 2012-10-13 |
| 1174761720 | Elizabeth Rachel Bakker | Speech-Language Pathologist | 12840 Alexander Street, Cedar Lake, IN 46303 | 2009-02-04 |
| 1982899654 | Terrence Scott Mcdermott | Dentist | 13315 Lincoln Plaza, Cedar Lake, IN 46303 | 2007-09-06 |
| 1568687937 | Terry Harman | Social Worker | 10800 W 33rd Ave, Cedar Lake, IN 46303 | 2007-04-13 |
| 1902992977 | Michael R Martell | Dentist | 12712 Wicker Avenue, Cedar Lake, IN 46303 | 2006-10-05 |
| 1346343035 | Hook Superx LLC | Durable Medical Equipment & Medical Supplies | 11115 W. 133rd Ave, Cedar Lake, IN 46303 | 2006-09-07 |
| 1215040142 | Illiana Eyecare Inc | Optometrist | 13115 Wicker Avenue, Suite E, Cedar Lake, IN 46303 | 2006-08-16 |
| 1184852402 | Claire Dugan Mcclintock | Speech-Language Pathologist | 12845 Parrish Ave, Julie Berg Speech Pathology, P.C., Cedar Lake, IN 46303 | 2009-06-25 |
| 1962425090 | Town of Cedar Lake | Emergency Medical Technician, Intermediate | 9430 W. 133rd Avenue, Cedar Lake, IN 46303-0459 | 2006-07-26 |
| Find all providers in zip 46303 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982956017 | Jean Marie Decavitch | Nurse Practitioner | 6831 W 133rd Ave, Cedar Lake, IN 46303 | 2012-10-13 |
| 1508837782 | Billie Ann Black | Nurse Practitioner | 13963 Morse St, Cedar Lake, IN 46303-9639 | 2006-01-27 |
| 1205243524 | Melissa Krzus | Nurse Practitioner | 13963 Morse St, Cedar Lake, IN 46303-9639 | 2014-07-18 |
| 1073935813 | Jillian Carter | Nurse Practitioner | 6831 W 133rd Ave, Cedar Lake, IN 46303-8989 | 2014-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386244176 | Mallory Lee Anslow | Nurse Practitioner | 10641 Deercrest Ln, Indianapolis, IN 46239-9690 | 2020-10-29 |
| 1285234237 | Vb Medical Group LLC | Nurse Practitioner | 10047 Whispering Wind Dr, Greenville, IN 47124-9704 | 2020-10-29 |
| 1518566397 | Stacey Renee Pulver | Nurse Practitioner | 13134 Hollow Oak Rd, Fort Wayne, IN 46845-2327 | 2020-10-22 |
| 1578162459 | Kourtney Marie Terry | Nurse Practitioner | 128 Miner Rd, Avilla, IN 46710-9690 | 2020-10-21 |
| 1780283630 | Dana L Yergler | Nurse Practitioner | 16632 Linfield Ct, Granger, IN 46530-7012 | 2020-10-21 |
| 1730788720 | Camille Mae Carl | Nurse Practitioner | 6441 Anna Louise Dr, Charlestown, IN 47111-8797 | 2020-10-20 |
| 1124626585 | Dustin Mikesell | Nurse Practitioner | 1000 E Main St Ste 104, Danville, IN 46122-1948 | 2020-10-16 |
| 1144828799 | Mina Desai-patel | Nurse Practitioner | 14698 Drayton Dr, Noblesville, IN 46062-8230 | 2020-10-15 |
| 1649878554 | Heather Ormiston-leclear | Nurse Practitioner | 3800 N Anthony Blvd # Cc1335, Fort Wayne, IN 46805-1430 | 2020-10-13 |
| 1023616125 | Kimberly Dawn Calloway | Nurse Practitioner | 5306 E Blocher Rd, Lexington, IN 47138-8803 | 2020-10-12 |
| Find all providers with the same taxonomy | ||||
| City | CEDAR LAKE |
| Zip Code | 46303 |
Please comment or provide details below to improve the information on MR. PATRICK ROLAND THIBEAULT.
| 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.