Individual provider Active NPI

Tina M Theriot, DC

  • Chiropractor
  • New Iberia, LA
National Provider Identifier
1275517047
Registry record updated Oct 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1036 Issued in LA
Practice address
612 Rue de Onetta
New Iberia, LA 70563-2163
Phone
(337) 367-6649
Fax
(888) 354-5793
NPI assigned
Dec 5, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1036 LA Primary

Addresses

Primary practice location

612 Rue de Onetta
New Iberia, LA 70563-2163

Mailing address

612 Rue de Onetta
New Iberia, LA 70563-2163
Phone (337) 367-6649

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111107000180 LA Practitioner - Chiropractic 0840463931

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

612 Rue de Onetta
New Iberia, LA 70563-2163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1036LAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Theriot Family Chiropractic Center Chiropractor CurrentSince Jul 1, 1996 Accepting new patients

Locations

612 Rue de Onetta
New Iberia, LA 70563
Phone (337) 367-6649

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224633600000",
    "number": "1275517047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 RUE DE ONETTA",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632163",
            "telephone_number": "337-367-6649",
            "fax_number": "888-354-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 RUE DE ONETTA",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632163",
            "telephone_number": "337-367-6649",
            "fax_number": "888-354-5793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THERIOT",
        "first_name": "TINA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2008-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Iberia, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; 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.