Madison Theriot Lestage, FNP-C
Individual provider Active NPI Nurse Practitioner · Vinton, LA
NPI 1174468995 · NPPES record last updated Apr 20, 2026
Key facts
- NPI
- 1174468995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 206785 (LA)
- Practice address
- 1311 Horridge St
Vinton, LA 70668-4531 - Phone
- (337) 324-8060
- NPI assigned
- Apr 20, 2026
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1311 Horridge St
Vinton, LA 70668-4531
212 Orchard Dr
Lake Charles, LA 70605-4444
Hospital & facility affiliations
- West Calcasieu Cameron Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260526004069 | LA | Practitioner - Nurse Practitioner | 7810467354 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 206785 | LA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thibodeaux Medical Clinic, LLC | Current |
Accepting new patients |
Locations
1311 Horridge St
Vinton, LA 70668
Phone (337) 324-8060
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 206785 | LA | Yes |
Addresses
Primary practice location
1311 Horridge St
Vinton, LA 70668-4531
Mailing address
212 Orchard Dr
Lake Charles, LA 70605-4444
Phone (337) 965-6984
Other providers in Vinton, LA
- Holistic Chiropractic and Diagnostic Center
- Alexis Elizabeth Juneau
- Keh Enterprises, Inc
- Lake Area Chiropractic Center, Inc.
- Lanes Pharmacy Inc
- Louisiana Diagnostic and Imaging
- Stephanie Lynn Marceaux
- Milton Outreach Ministries
- Osteopractic Physical Therapy of Southwest Louisiana LLC
- Physical Therapy Clinic of Vinton LLC
All providers in Vinton, LA · Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.