Individual provider Active NPI

Craig Gerard Hebert, P.T.

  • Physical Therapist
  • Thibodaux, LA
National Provider Identifier
1043373947
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
00299 Issued in LA
Practice address
104 E Bayou Rd
Thibodaux, LA 70301-3036
Phone
(985) 446-3736
Fax
(985) 446-3701
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 00299 LA Primary

Addresses

Primary practice location

104 E Bayou Rd
Thibodaux, LA 70301-3036

Mailing address

723 Rosedown Dr
Thibodaux, LA 70301-8044
Phone (985) 447-7909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101013001263 LA Practitioner - Physical Therapist in Private Practice 5294851572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Louisiana State University School of Medicine in New Orleans, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thibodaux Physical Therapy LLCGroup PAC ID 6103221627, 4 clinicians

Practice addresses (Care Compare)

104 E Bayou Rd
Suite C
Thibodaux, LA 70301-3036
Phone (985) 446-3736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
299LAMDProfessional Counselor
00299LAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thibodaux Physical Therapy LLC Physical Therapist CurrentSince Aug 1, 2021 Accepting new patients

Locations

104 E Bayou Rd
Ste C
Thibodaux, LA 70301
Phone (985) 446-3736

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043373947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 ROSEDOWN DR",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703018044",
            "telephone_number": "985-447-7909",
            "fax_number": "985-446-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E BAYOU RD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703013036",
            "telephone_number": "985-446-3736",
            "fax_number": "985-446-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBERT",
        "first_name": "CRAIG",
        "middle_name": "GERARD",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "00299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.