Judy Anne Thibault

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

200440287RN Issued in OR

Practice address

203 Munsel Creek Loop
Florence, OR 97439-9235

Phone

(541) 999-7109

NPI assigned

Jun 16, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1560643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1396305082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 MUNSEL CREEK LOOP",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974399235",
            "telephone_number": "541-999-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 MUNSEL CREEK LOOP",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974399235",
            "telephone_number": "541-999-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBAULT",
        "first_name": "JUDY",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-16",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "OR",
            "license": "200440287RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Synergy Medical Systems, Inc.
• Joan M Taber, RD
• Andrew Ridghaus Tash
• Evan Matthew Tavakoli, M.D.
• Amy Lynn Tensen, PA-C
• Thomas J. Hunt DMD PC
• Thrifty Payless Inc
• Tiffany-Davis Drug Co.
• Lina Turner, PHARMD
• Shane Day Turner, PHARMD

• Community Health Registered Nurse in Florence, OR
• Providers in Florence, OR by specialty
• Community Health Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.