Garett Thibodeaux LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1536-564T Issued in LA

Legal business name

GARETT THIBODEAUX LLC

Practice address

1525 E Bridge St
Breaux Bridge, LA 70517-3401

Phone

(337) 332-4473

Fax

(337) 332-4015

NPI assigned

Mar 13, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Garett Thibodeaux, ODNPI 1831106335

Title

Optometrist

Phone

(337) 332-4473

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Garett Paul Thibodeaux, O.D.

  • Optometrist
  • Breaux Bridge, LA
  • NPI 1831106335

  1153584123

  Same PAC ID

Locations

Practitioners 1

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

• Garett Paul Thibodeaux, O.D.

  • Optometrist
  • Breaux Bridge, LA
  • NPI 1831106335
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339545600000",
    "number": "1174898977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 E BRIDGE ST",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705173401",
            "telephone_number": "337-332-4473",
            "fax_number": "337-332-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E BRIDGE ST",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705173401",
            "telephone_number": "337-332-4473",
            "fax_number": "337-332-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARETT THIBODEAUX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2012-06-13",
        "status": "A",
        "authorized_official_last_name": "THIBODEAUX",
        "authorized_official_first_name": "GARETT",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "337-332-4473",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1536-564T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1582662",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Breaux Bridge, LA
• Providers in Breaux Bridge, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.