Jean Thibault, CRNP, MPH

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5004969 Issued in NC

Practice address

4525 Cameron Valley Parkway
Charlotte, NC 28211-3546

Phone

(704) 302-8310

NPI assigned

Jan 18, 2010

Last updated

Jan 31, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Joseph's Hospital, Inc.Group PAC ID 1658274287, shared by 5 NPIs, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Josephs Hospital Hospital, Tampa, FL, CCN 100075

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jean.thibaultaprn@direct.mybaycare.org

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

• St. Joseph's Hospital, Inc.

  • Primary Care Clinic/Center
  • St Petersburg, FL
  • NPI 1710036868
  Medicare reassignment NPD
• St. Joseph's Hospital, Inc.

  • Primary Care Clinic/Center
  • Tampa, FL
  • NPI 1992854038
  Medicare reassignment NPD
• University of Alabama at Birmingham

  dba UAB Health Center Montgomery

  • Internal Medicine Physician
  • Montgomery, AL
  • NPI 1184738478
  Medicare reassignment NPD
• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment NPD
• St Joseph's Hospital Inc

  dba Chronic Complex Clinic

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1740901578
  NPD
• University of Alabama at Birmingham

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1447145818
  NPD
• University of Alabama at Birmingham

  dba 1917 Clinic

  • Infusion Therapy Clinic/Center
  • Birmingham, AL
  • NPI 1861704934
  NPD
• St. Joseph's Hospital, Inc.

  dba St. Joseph's Hospital

  • Clinical Medical Laboratory
  • Tampa, FL
  • NPI 1316531999
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Joseph's Hospital, Inc.

  dba St. Joseph's Women's Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1346519816
  Care Compare affiliation
• St. Joseph's Hospital, Inc.

  dba St. Joseph's Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1881632818
  Care Compare affiliation

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

{
    "created_epoch": "1263772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1124359021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW STREET",
            "address_2": "EAST BLDG 2ND FLOOR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33759",
            "telephone_number": "727-281-9390",
            "fax_number": "813-635-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 CAMERON VALLEY PARKWAY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282113546",
            "telephone_number": "704-302-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBAULT",
        "first_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "CRNP, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-18",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-104989",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004773",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ilka Dietlinde Theruvath, M.D., PH.D.
• Tom Prakash Theruvath, M.D.
• Lars Thestrup, MD
• Theunisse PT Inc
• Analeese Barbara Theys
• Jody Ann Thibault, CSAC
• Justin Thibault, PT, DPT
• Craig Thibeault, RPH
• Jessica Turner Thiel, NP
• Kiley Costner Thiel, LCMHCS

• Family Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.