THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION (NPI# 1114339181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114339181 |
| Entity Type | Organization |
| Organization Name | THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION |
| Other Organization Name | THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION - NEUROLOGY |
| Practice Address |
604 N Acadia Rd Suite 410 Thibodaux LA 70301-4897 |
| Mailing Address |
Po Box 5478 Thibodaux LA 70302-5478 |
| Practice Telephone | 9854933090 |
| Practice Fax Number | 9854933091 |
| Mailing Telephone | 9854933090 |
| Mailing Fax Number | 9854933091 |
| Enumeration Date | 2014-05-27 |
| 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 | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2376365 | 05 |
| Other Name | Type Code |
|---|---|
| Thibodaux Regional Network Development Corporation - Neurology | Doing Business As Name - Organization |
| Thibodaux Regional Neurology Clinic | 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 |
| 1215355128 | Thibodaux Regional Network Development Corporation | Internal Medicine | 726 N Acadia Rd, Ste 3300, Thibodaux, LA 70301-4847 | 2014-03-29 |
| 1396175857 | Thibodaux Regional Network Development Corporation | Pain Medicine | 726 N Acadia Rd, Ste 2400, Thibodaux, LA 70301-4847 | 2013-11-20 |
| 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 SUITE 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 |
| 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 |
| 1306125133 | Thibodaux Regional Network Development Corporation | Internal Medicine | 604 N Acadia Rd, Ste 410, Thibodaux, LA 70301-4897 | 2011-08-10 |
| 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 |
| Find all providers in the same location | ||||
| 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 | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962899872 | Tashfin Samiul Huq | Psychiatry & Neurology | 726 N Acadia Rd Ste 2300, Thibodaux, LA 70301-5078 | 2015-04-17 |
| 1225411002 | Ebony Mckinnies | Psychiatry & Neurology | 726 N Acadia Rd Ste 2300, Thibodaux, LA 70301-5078 | 2015-06-30 |
| 1538182118 | Andrew Roger Gustavson | Psychiatry & Neurology | 604 N Acadia Rd, Suite 411, Thibodaux, LA 70301-4897 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598374746 | Neupro LLC | Psychiatry & Neurology | 17086 Abita Ave, Prairieville, LA 70769-3369 | 2020-07-23 |
| 1548826803 | Brainwire LLC | Psychiatry & Neurology | 128 Keeneland Ln, Lafayette, LA 70503-6213 | 2019-05-13 |
| 1417474339 | Ascension Medical Associates, LLC | Psychiatry & Neurology | 37325 Market Place Dr., Suite D, Prairieville, LA 70769 | 2017-08-23 |
| 1881056778 | Miguel Federico Molina | Psychiatry & Neurology | 2912 Robert St, New Orleans, LA 70125-5033 | 2016-03-22 |
| 1750743621 | Jessica Chachere Baity | Psychiatry & Neurology | 1542 Tulane Ave Fl 7, New Orleans, LA 70112-2865 | 2016-03-22 |
| 1629451638 | Chaitanya Amrutkar | Psychiatry & Neurology | 1811 E Bert Koun Loop Ste 120, Shreveport, LA 71105-5741 | 2015-07-08 |
| 1841684263 | Oliver Achi | Psychiatry & Neurology | 2312 E Main St Ste C, New Iberia, LA 70560-4064 | 2015-03-24 |
| 1104232289 | Martha Montgomery Robinson | Psychiatry & Neurology | 1430 Tulane Ave # 8065, New Orleans, LA 70112-2632 | 2014-07-09 |
| 1124439328 | Tanya Kapoor-maini | Psychiatry & Neurology | 120 Ochsner Blvd Ste 320, Gretna, LA 70056 | 2014-05-12 |
| 1275952137 | Eleni Antzoulatos | Psychiatry & Neurology | 1430 Tulane Ave. #sl-50, New Orleans, LA 70112-2699 | 2014-04-08 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION.
| 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.