THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION (NPI# 1184963613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184963613 |
| Entity Type | Organization |
| Organization Name | THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION |
| Other Organization Name | THIBODAUX REGIONAL WOMEN'S CLINIC |
| Practice Address |
604 N Acadia Rd Ste 500 Thibodaux LA 70301-4743 |
| Mailing Address |
Po Box 5478 Thibodaux LA 70302-5478 |
| Practice Telephone | 9854481216 |
| Practice Fax Number | 9854468765 |
| Mailing Telephone | 9854481216 |
| Mailing Fax Number | 9854468765 |
| Enumeration Date | 2013-02-04 |
| 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 |
|---|---|---|---|---|---|
| N | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
Allopathic & Osteopathic Physicians | ||
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2324845 | 05 |
| Other Name | Type Code |
|---|---|
| Thibodaux Regional Network Development Corporation - Women's Center | Doing Business As Name - Organization |
| Thibodaux Regional Women's 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 |
| 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 |
| 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 STE 500 |
| City | THIBODAUX |
| State | LA |
| Zip Code | 70301-4743 |
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326262379 | Transitions Obgyn LLC | Obstetrics & Gynecology | 216 Davis Dr, Thibodaux, LA 70301-8020 | 2007-04-12 |
| 1992125355 | Johnathan Lloyd Wise | Obstetrics & Gynecology | 406 N Acadia Rd, Thibodaux, LA 70301-4856 | 2014-04-23 |
| 1235572355 | Rhandi A Wise | Obstetrics & Gynecology | 406 N Acadia Rd, Thibodaux, LA 70301 | 2013-04-08 |
| 1285861062 | Christopher Z Rodrigue Jr. | Obstetrics & Gynecology | 506 N Acadia Rd, Thibodaux, LA 70301 | 2009-06-18 |
| 1295962165 | Anne E Rodrigue | Obstetrics & Gynecology | 506 N Acadia Rd, Thibodaux, LA 70301 | 2009-06-17 |
| 1225229552 | Nicole D Prosperie | Obstetrics & Gynecology | 506 N Acadia Rd, Thibodaux, LA 70301-4862 | 2007-08-01 |
| 1922218163 | Amy Roundtree Ashton | Obstetrics & Gynecology | 506 N Acadia Rd, Thibodaux, LA 70301-4862 | 2007-05-23 |
| 1841315504 | Judith C Blaise Md LLC | Obstetrics & Gynecology | 604 N Acadia Rd, Suite 202, Thibodaux, LA 70301-4847 | 2007-03-20 |
| 1528179512 | John H Milek | Obstetrics & Gynecology | 506 N Acadia Rd, Thibodaux, LA 70301 | 2006-08-31 |
| 1275578130 | Judith Canella Blaise | Obstetrics & Gynecology | 602 N Acadia Rd, Thibodaux, LA 70301-4823 | 2006-06-17 |
| 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.