Courtney Lynn Thibeault, DNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

APRN01781 Issued in RI

Practice address

1 Evergreen Dr
East Providence, RI 02914-1506

Phone

(401) 438-3250

NPI assigned

Jan 28, 2018

Last updated

Dec 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Blueprint Healthcare LLC

  • Internal Medicine Physician
  • Fitchburg, MA
  • NPI 1467927483
  NPD
• Premier Healthcare Services, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Dartmouth, MA
  • NPI 1174089163
  NPD
• Premier Healthcare Services, LLC

  • Internal Medicine Physician
  • Rockville, MD
  • NPI 1881068898
  NPD (past)

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

{
    "created_epoch": "1517097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1346748043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2153 DEPT 40338",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352879386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EVERGREEN DR",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141506",
            "telephone_number": "401-438-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBEAULT",
        "first_name": "COURTNEY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-28",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2274057",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "RI",
            "license": "APRN01781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Terlato, MD
• The Arc of Blackstone Valley
• The Lactation Network LLC
• The Movement Lab
• The Summit Management Group, LLC (Visiting Angels)
• Heather Ann Thibodeau, MSW
• Budio J Thomas, DO
• Sarah Anne Thomas, OTR
• Michael A Thursby, DO
• Shiqiang Tian, MD

• Adult Health Nurse Practitioner in East Providence, RI
• Providers in East Providence, RI by specialty
• Adult Health Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.