Organization Active NPI

Thibodaux Internal Medicine Associates,Inc.

  • Internal Medicine Physician
  • Thibodaux, LA
National Provider Identifier
1124270749
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
THIBODAUX INTERNAL MEDICINE ASSOCIATES,INC.
Practice address
142 Rue Marguerite
Thibodaux, LA 70301-6738
Phone
(985) 446-2131
NPI assigned
Oct 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Authorized official

Name
Leo P Hebert
Title
Manager
Phone
(985) 446-2131

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary
Preferred Provider Organization 305R00000X 09201R LA

Addresses

Primary practice location

142 Rue Marguerite
Thibodaux, LA 70301-6738

Mailing address

142 Rue Marguerite
Thibodaux, LA 70301-6738
Phone (985) 446-2131

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200313000770 LA Part B Supplier - Clinic/Group Practice 3779911367 Receives reassigned benefits from 2 practitioners
Practice locations: Thibodaux, LA

National Provider Directory

National Provider Directory

Locations

142 Rue Marguerite
Thibodaux, LA 70301
Phone (985) 446-2131

142 Rue Marguerite
#B
Thibodaux, LA 70301
Phone (985) 446-2131

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743638400000",
    "number": "1124270749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 RUE MARGUERITE",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703016738",
            "telephone_number": "985-446-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 RUE MARGUERITE",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703016738",
            "telephone_number": "985-446-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIBODAUX INTERNAL MEDICINE ASSOCIATES,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-14",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A",
        "authorized_official_last_name": "HEBERT",
        "authorized_official_first_name": "LEO",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "985-446-2131"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "LA",
            "license": "09201R",
            "primary": false
        }
    ],
    "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 Apr 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.