MICHAEL STANLEY THIBAULT (NPI# 1659324515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659324515 |
| Entity Type | Individual |
| Full Name | MICHAEL STANLEY THIBAULT |
| Credential | PAC |
| Practice Address |
25 Tamarack Avenue Advanced Derm Care, PC Danbury CT 06811 |
| Practice Telephone | 2037978990 |
| Practice Fax Number | 2037487861 |
| Mailing Telephone | 2037978990 |
| Mailing Fax Number | 2037487861 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2011-10-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 001389 | CT | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | PA 1933 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | PA LICENSE | PA1933 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700922291 | Michael Dennis Thibault | Pharmacist | 82 Mapleton Rd, Grosse Pointe Farms, MI 48236-3615 | 2007-01-30 |
| Street Address |
25 TAMARACK AVENUE ADVANCED DERM CARE, PC |
| City | DANBURY |
| State | CT |
| Zip Code | 06811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285285361 | Domonique Danza | Massage Therapist | 34 Mill Plain Rd, Danbury, CT 06811 | 2019-09-20 |
| 1538683552 | Walgreen Co | Pharmacy | 113/115 Mill Plain Rd, Danbury, CT 06811 | 2017-08-01 |
| 1366980484 | Heather H Thebodo | Pharmacist | 47-49 Lake Avenue Extention, Danbury, CT 06811 | 2017-02-09 |
| 1851848824 | Ellen Lyall | Dental Hygienist | 6 Field Road, Danbury, CT 06811 | 2016-09-07 |
| 1558753574 | Ctuc01 | Clinic/Center | 100 Mill Plain Road, Danbury, CT 06811 | 2015-02-27 |
| 1063757730 | Rabiya Ansari-johnston | Occupational Therapist | 1 Glen Hill Road, Danbury, CT 06811 | 2012-12-06 |
| 1407167851 | Appalachian Chiropractic and Wellness LLC | Chiropractor | 103 Mill Plain Road, Suite 1, Danbury, CT 06811 | 2010-06-30 |
| 1730395294 | David P Rentler | Psychologist | 33 and One Half Pembroke Rd, Danbury, CT 06811 | 2007-05-14 |
| 1770704074 | Loretta Marie Osik | Naturopath | One Maplewood Dr, Danbury, CT 06811 | 2007-05-02 |
| 1932227733 | Lorena Jean Tesbir | Counselor | 2 Glen Hill Road, Danbury, CT 06811 | 2007-03-27 |
| Find all providers in zip 06811 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396382685 | Optimum Regenerative Care LLC | Family Medicine | 46 Benson Dr, Danbury, CT 06810-7231 | 2019-12-05 |
| 1881237709 | Carla M Mota | Family Medicine | 120 Main St Fl 4, Danbury, CT 06810-7834 | 2019-10-23 |
| 1639520323 | Jaime Verastegui | Family Medicine | 24 Hospital Ave, Danbury, CT 06810-6099 | 2016-06-24 |
| 1699017277 | Nini Min Aung | Family Medicine | 57 North St, Suite 302, Danbury, CT 06810-5660 | 2013-03-21 |
| 1316253123 | Swati Srivastava | Family Medicine | 79 Sand Pit Rd, Danbury, CT 06810-4005 | 2010-08-31 |
| 1104142090 | Cb Family Medicine LLC | Family Medicine | 93 West St, Unit # 3, Danbury, CT 06810-6525 | 2010-04-16 |
| 1467785139 | Edgard Jose Salazar | Family Medicine | 8 Delay St, Danbury, CT 06810-6654 | 2009-09-14 |
| 1477715670 | Gabriella Caroline Gellrich | Family Medicine | 8 Delay St, Danbury, CT 06810-6654 | 2008-06-28 |
| 1932130168 | Cornelius Ferreira | Family Medicine | 95 Locust Ave, Danbury, CT 06810-6148 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225638299 | Alyssa Mary Brown | Family Medicine | 82 Welles Dr, Newington, CT 06111-2625 | 2020-10-29 |
| 1598370389 | Korinne Fern Croce X | Family Medicine | 52 Meadowood Dr, New Milford, CT 06776-5732 | 2020-09-09 |
| 1619580263 | Chelsea Nicole Alves | Family Medicine | 111 Connecticut Blvd, East Hartford, CT 06108-3015 | 2020-08-24 |
| 1679108492 | Sky Health Group PC | Family Medicine | 64 Blue Ridge Drive, Waterbury, CT 06704 | 2020-03-12 |
| 1598397192 | Healthmed Family Care | Family Medicine | 1209 S Broad St, Wallingford, CT 06492-1714 | 2020-02-11 |
| 1457991333 | Diane Iannini | Family Medicine | 16 Bridge End Farm Ln, Sandy Hook, CT 06482-1055 | 2020-01-08 |
| 1801455761 | Steven John Rigatti | Family Medicine | 157 Uconn Ave, Glastonbury, CT 06033-1348 | 2019-06-13 |
| 1063071017 | Better Life- Better Health Pllc | Family Medicine | 728 Broad Street Ext # B, Waterford, CT 06385-1345 | 2019-06-12 |
| 1336703586 | Shazia Josephine Joseph | Family Medicine | 12 Village St Ste 5, North Haven, CT 06473-3828 | 2019-04-23 |
| 1760951115 | Health Quest Medical Practice, PC | Family Medicine | 29 Hospital Hill Rd Ste 1400, Sharon, CT 06069-2095 | 2018-11-15 |
| Find all providers with the same taxonomy | ||||
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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.