Benjamin Todd Thibodeaux, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1278 Issued in LA

Practice address

1501 Rees St
Breaux Bridge, LA 70517-4309

Phone

(337) 332-2225

Fax

(337) 332-6097

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2001

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Avaeli Chiropractic, LLC

  • Chiropractor
  • Breaux Bridge, LA
  • NPI 1649549981
  Medicare reassignment NPD Authorized official
• Breaux Bridge Chiropractic

  • Chiropractor
  • Breaux Bridge, LA
  • NPI 1184770885
  NPD (past)
• Lafayette Chiropractic Physician'S Group, Inc

  • Chiropractor
  • Lafayette, LA
  • NPI 1659575488
  NPD (past)
• Pinhook Chiropractic Clinic

  • Chiropractor
  • Lafayette, LA
  • NPI 1215091855
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1295832624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705170097",
            "telephone_number": "337-945-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 REES ST",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705174309",
            "telephone_number": "337-332-2225",
            "fax_number": "337-332-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAUX",
        "first_name": "BENJAMIN",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1295832624",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Gloria Kern Center, Inc.
• The Gloria Kern Center, Inc.
• The Gloria Kern Center, Inc.
• The Travel Concierge, LLC
• Jeanne Dauphine Theriot, M.D.
• Garett Paul Thibodeaux, O.D.
• Kevin James Thibodeaux
• Erin Thomas, RPH
• Loreal Thomas
• Rebecca M Thompson

• All providers in Breaux Bridge, LA
• Chiropractor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.