NICHOLLS STATE UNIVERSITY (NPI# 1861881435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1861881435 |
Entity Type | Organization |
Organization Name | NICHOLLS STATE UNIVERSITY |
Other Organization Name | NICHOLLS STATE SPORTS MEDICINE |
Practice Address |
906 E 1st St Thibodaux LA 70301-6701 |
Mailing Address |
5050 Spring Valley Rd Dallas TX 75244-3995 |
Practice Telephone | 9854484837 |
Practice Fax Number | 9723673451 |
Mailing Telephone | 8005559073 |
Mailing Fax Number | 9723673452 |
Enumeration Date | 2015-01-20 |
Last Update Date | 2015-01-20 |
Authorized Official Name | MOUZON BASS III (AGENT) |
Authorized Official Telephone | 18005559073 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Nicholls state sports medicine | Doing Business As Name - Organization |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | NICHOLLS STATE UNIVERSITY | 906 E 1st St, Thibodaux, LA 70301-6701 |
Street Address |
906 E 1ST ST |
City | THIBODAUX |
State | LA |
Zip Code | 70301-6701 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295227635 | The Foundation for The Advancement of A Strategic Science of Teaching | Behavioral Analyst | 906 E 1st St, Thibodaux, LA 70301-6701 | 2018-06-01 |
1700374220 | Braden Patrick Jarrard | Specialist/Technologist | 906 E 1st St, Thibodaux, LA 70301-6701 | 2018-04-30 |
1629577655 | Travis James Rousselle | Specialist/Technologist | 906 E 1st St, Thibodaux, LA 70301-6701 | 2018-02-05 |
1154859171 | Maureen Brooks | Specialist/Technologist | 906 E 1st St, Thibodaux, LA 70301-6701 | 2017-06-03 |
1821532888 | Cheyenne Naquin | Specialist/Technologist | 906 E 1st St, Thibodaux, LA 70301-6701 | 2016-12-11 |
1154865129 | Holden Melerine | Student in an Organized Health Care Education/Training Program | 906 E 1st St, Thibodaux, LA 70301-6701 | 2016-12-11 |
1841734811 | Jordan Lee Hartman | Student in an Organized Health Care Education/Training Program | 906 E 1st St, Thibodaux, LA 70301-6701 | 2016-12-11 |
1861935520 | Kaelin Brett Scivicque | Student in an Organized Health Care Education/Training Program | 906 E 1st St, Thibodaux, LA 70301-6701 | 2016-11-29 |
1386187136 | Destiny Rose Fitch | Student in an Organized Health Care Education/Training Program | 906 E 1st St, Thibodaux, LA 70301-6701 | 2016-11-28 |
1487001970 | Timothy Quinton Nease II | Specialist/Technologist | 906 E 1st St, Sports Medicine-basketball, Thibodaux, LA 70301-6701 | 2016-05-16 |
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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 | 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 |
---|---|---|---|---|
1871792051 | Adrienne C Robertson | Family Medicine | 1001 Jackson St, Thibodaux, LA 70301-3227 | 2007-07-17 |
1760692081 | Alan B. Fortier Jr. | Family Medicine | 804 S Acadia Rd, Thibodaux, LA 70301-4850 | 2007-05-23 |
1518085679 | Sayes Family Medical Corporation Apmc | Family Medicine | 206 E 2nd St, Thibodaux, LA 70301-3306 | 2007-03-27 |
1891878427 | James B Hyatt | Family Medicine | 1101 Audubon Ave Ste S1, Thibodaux, LA 70301-4957 | 2006-10-24 |
1083727838 | Raja Talluri Md A Professional | Family Medicine | 1214 Cardinal Dr, Thibodaux, LA 70301-4815 | 2006-08-16 |
1881611820 | Anna Marie Falcon | Family Medicine | 210 Ardoyne Avenue, Thibodaux, LA 70301 | 2006-07-16 |
1972529402 | Billy Wray Hillman Jr. | Family Medicine | 426 Highway 308, Thibodaux, LA 70301-5752 | 2006-07-15 |
1396738670 | John Wesley Magee IIi | Family Medicine | 804 South Acadia Road, Thibodaux, LA 70301 | 2005-08-23 |
1770903205 | Brandon Michael Gil | Family Medicine | 602 N Acadia Rd, Thibodaux, LA 70301 | 2014-04-23 |
1710244041 | Joshua Jesus Huval | Family Medicine | 804 S Acadia Rd, Thibodaux, LA 70301-4850 | 2012-04-11 |
Find all providers in THIBODAUX |
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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.