Derrick F Thibodeaux (NPI# 1659762839, PAC ID# 4385946565) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1659762839 |
| PAC ID by PECOS | 4385946565 |
| Professional Enrollment ID | I20160105001532 |
| Full Name | Derrick F Thibodeaux |
| Organization Legal Name | THE FAMILY CARE CENTER OF SOUTHWEST LOUISIANA, LLC |
| Address |
2345 Sampson St Westlake LA 70669-2711 |
| Phone Number | 3374391484 |
| Gender | M |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 1456445055 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190013 | WEST CALCASIEU CAMERON HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 4200 Nelson Rd, Lake Charles, LA 70605-4118 | 3184746370 | CALCASIEU EMERGENCY GROUP LLC |
| 1020 W Fertita Blvd, Leesville, LA 71446-4645 | 3372395278 | KISATCHIE EMERGENCY GROUP LLC |
| 2345 Sampson St, Westlake, LA 70669-2711 | 3374391484 | THE FAMILY CARE CENTER OF SOUTHWEST LOUISIANA, LLC |
| Organization Legal Name | THE FAMILY CARE CENTER OF SOUTHWEST LOUISIANA, LLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jody George | Family Medicine | The Family Care Center of Southwest Louisiana, LLC | 2345 Sampson St, Westlake, LA 70669-2711 |
| Ramona Leigh Whittington | Nurse Practitioner | The Family Care Center of Southwest Louisiana, LLC | 2345 Sampson St, Westlake, LA 70669-2711 |
| Street Address |
2345 SAMPSON ST |
| City | WESTLAKE |
| State | LA |
| Zip | 70669-2711 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jody George | Family Medicine | The Family Care Center of Southwest Louisiana, LLC | 2345 Sampson St, Westlake, LA 70669-2711 |
| Ramona Leigh Whittington | Nurse Practitioner | The Family Care Center of Southwest Louisiana, LLC | 2345 Sampson St, Westlake, LA 70669-2711 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jana Rosenberg Kingrey | Chiropractic | Kingrey Chiropractic LLC | 902 Sampson St, Westlake, LA 70669-5311 |
| Charles Timothy Kingrey Jr. | Chiropractic | Kingrey Chiropractic LLC | 902 Sampson St, Westlake, LA 70669-5311 |
| City | WESTLAKE |
| Zip Code | 70669 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | WESTLAKE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Derrick F Thibodeaux.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.