Individual provider Active NPI

Beau Isaac Porche, D.C.

  • Chiropractor
  • Houma, LA
National Provider Identifier
1285674325
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC1380 Issued in LA
Practice address
430 Corporate Dr.
Houma, LA 70360
Phone
(985) 873-8586
Fax
(985) 873-8565
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC1380 LA Primary

Addresses

Primary practice location

430 Corporate Dr.
Houma, LA 70360

Mailing address

430 Corporate Dr.
Houma, LA 70360
Phone (985) 873-8586

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130122000043 LA Practitioner - Chiropractic 8729230776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2000 Audobon Ave
Suite D
Thibodaux, LA 70301-5075
Phone (985) 447-2225

430 Corporate Dr
Houma, LA 70360-2461
Phone (985) 873-8586

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC1380LAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Houma-Thibodaux Spine and Rehabilitation LLC Chiropractor CurrentSince Sep 29, 2012 Accepting new patients

Locations

430 Corporate Dr
Houma, LA 70360
Phone (985) 873-8586

2000 Audubon Ave
Ste D
Thibodaux, LA 70301
Phone (985) 447-2225

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1285674325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 CORPORATE DR.",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "70360",
            "telephone_number": "985-873-8586",
            "fax_number": "985-873-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 CORPORATE DR.",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "70360",
            "telephone_number": "985-873-8586",
            "fax_number": "985-873-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORCHE",
        "first_name": "BEAU",
        "middle_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "DC1380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 12, 2016; 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.