Thibodaux Regional Urgent Care LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

THIBODAUX REGIONAL URGENT CARE LLC

Practice address

1411 Saint Charles St
Houma, LA 70360-3964

Phone

(985) 709-0136

Fax

(985) 709-0527

NPI assigned

Aug 20, 2021

Organization subpart

No

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

Authorized official

Name

Kim L Boudreaux, MBA

Title

Contract Manager

Phone

(985) 493-4907

Specialties & licenses 1

Addresses

Other names 1

• Thibodaux Regional Urgent Care - Houma Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Thibodaux Regional Urgent Care LLC

  • Urgent Care Clinic/Center
  • Thibodaux, LA
  • NPI 1013683903

  O20211021001859

  Same enrollment
• Thibodaux Regional Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Gray, LA
  • NPI 1790547370

  O20211021001859

  Same enrollment

Tax ID family

Thibodaux Regional Urgent Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Thibodaux Regional Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Gray, LA
  • NPI 1790547370
  NPD tax ID

Locations

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

• Frances Kathryn Crochet, PA-C

  • Physician Assistant
  • Houma, LA
  • NPI 1821369885
  NPD
• Giselle Dicostanzo, NP

  • Family Nurse Practitioner
  • Gray, LA
  • NPI 1063118941
  NPD
• Seth Guidry, MD

  • Internal Medicine Physician
  • Thibodaux, LA
  • NPI 1144607151
  NPD
• Crystal Hill, FNP-C

  • Family Nurse Practitioner
  • Morgan City, LA
  • NPI 1790140549
  NPD
• Christopher Powell, PA

  • Medical Physician Assistant
  • Houma, LA
  • NPI 1992802987
  NPD
• Caroline Camille Robichaux, MD

  • Family Medicine Physician
  • Houma, LA
  • NPI 1174083620
  NPD
• Matthew Taylor, MD

  • Family Medicine Physician
  • Thibodaux, LA
  • NPI 1902434368
  NPD

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1154097996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 N ACADIA RD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014823",
            "telephone_number": "985-493-4740",
            "fax_number": "985-446-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 SAINT CHARLES ST",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703603964",
            "telephone_number": "985-709-0136",
            "fax_number": "985-709-0527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIBODAUX REGIONAL URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-20",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A",
        "authorized_official_last_name": "BOUDREAUX",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CONTRACT MANAGER",
        "authorized_official_telephone_number": "985-493-4907",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thibodaux Regional Urgent Care - Houma",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Thibodaux Regional Urgent Care - Houma",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lois T Theriot
• Melissa Theriot, MCD, CCC,CLP
• Mitchell P Theriot, DDS
• Myrn Theriot, BA
• Thibodaux Regional Network Development Corporation
• Bernadette Thibodaux, LAC, CCGC
• Crystal Thibodaux
• Lisa Thibodeaux, LCSW
• Nicole Thieler, D.D.S.
• Crystal Lynn Thomas, PHARM.D.

• All providers in Houma, LA
• Urgent Care Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.