NPIMap

Organization Active NPI

Thibodaux Regional Urgent Care LLC

Doing business as Thibodaux Regional Urgent Care - Houma

  • Urgent Care Clinic/Center
  • Houma, LA
National Provider Identifier
1154097996
Registry record updated Nov 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
THIBODAUX REGIONAL URGENT CARE LLC
Doing business as
Thibodaux Regional Urgent Care - Houma
Practice address
1411 Saint Charles St
Houma, LA 70360-3964
Phone
(985) 709-0136
Fax
(985) 709-0527
NPI assigned
Aug 20, 2021
Last updated
Nov 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2026

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

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1411 Saint Charles St
Houma, LA 70360-3964

Mailing address

602 N Acadia Rd
Thibodaux, LA 70301-4823
Phone (985) 493-4740

Other names 1

  • Thibodaux Regional Urgent Care - Houma Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211021001859 LA Part B Supplier - Clinic/Group Practice 4486042553 Receives reassigned benefits from 19 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gray, LA; Houma, LA; Thibodaux, LA

Other NPIs on the same Medicare enrollment 2

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2059406Thibodaux Regional Urgent Care1411 Saint Charles Street, Houma, LA 70360Certificate of waiverMay 21, 2027

National Provider Directory

National Provider Directory
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.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793836800000",
    "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": "2026-11-05",
        "certification_date": "2026-11-05",
        "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"
        }
    ]
}

Other providers in Houma, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2026; 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.