Kourtney Thibodeaux, PSS

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1634 Ryan St
Lake Charles, LA 70601-5949

Phone

(337) 602-6391

Fax

(337) 602-6392

NPI assigned

Aug 26, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Kingdom Expressions LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lake Charles, LA
  • NPI 1346785367
  NPD

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1134848674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 RYAN ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015949",
            "telephone_number": "337-602-6391",
            "fax_number": "337-602-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 RYAN ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015949",
            "telephone_number": "337-602-6391",
            "fax_number": "337-602-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAUX",
        "first_name": "KOURTNEY",
        "name_prefix": "Mrs.",
        "credential": "PSS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-26",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colby Ryan Thibodeaux, FNP
• Elise Thibodeaux
• Emily Granger Thibodeaux, FNP
• James Thibodeaux, PHARMD.
• Joel D Thibodeaux, M.D.
• Megan Leblanc Thibodeaux, NP
• Bridgette Annette Thierry
• Mareka Thierry
• Navdeep K Thind, D.M.D.
• Thomas B Ford MD AMC

• Case Manager/Care Coordinator in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.