Victor Gaston Theriault, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

014544 Issued in LA

Practice address

2905 E South Blvd
Montgomery, AL 36116-2501

Phone

(334) 420-5001

Fax

(334) 420-0160

NPI assigned

Jul 5, 2005

Last updated

Mar 26, 2025By the provider in NPPES

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, AL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family PracticeAlso: General Practice

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health Services IncGroup PAC ID 1557324811, shared by 14 NPIs, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jackson Hospital & Clinic Inc Hospital, Montgomery, AL, CCN 010024

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: victor.theriault.1@14429.direct.athenahealth.com

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.

• Health Services Inc

  dba Hayneville Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Hayneville, AL
  • NPI 1598788218
  Medicare reassignment NPD
• Health Services Inc

  dba Montevallo Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Montevallo, AL
  • NPI 1891257390
  Medicare reassignment NPD
• Jeffcare

  dba JeffCare East Jefferson

  • Federally Qualified Health Center (FQHC)
  • Metairie, LA
  • NPI 1518383785
  Medicare reassignment NPD
• Victor Theriault MD

  • Family Medicine Physician
  • Bogalusa, LA
  • NPI 1164500906
  NPD (past) Authorized official
• Health Services Inc

  dba River Region Health Center

  • Federally Qualified Health Center (FQHC)
  • Montgomery, AL
  • NPI 1205844719
  NPD
• Health Services Inc

  dba Autaugaville Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Autaugaville, AL
  • NPI 1992727853
  NPD
• Health Services, Inc.

  dba Living Well Specialty Clinic

  • Federally Qualified Health Center (FQHC)
  • Montgomery, AL
  • NPI 1184284986
  NPD
• Jeffcare

  dba JeffCare West Jefferson

  • Federally Qualified Health Center (FQHC)
  • Marrero, LA
  • NPI 1154747327
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jackson Hospital & Clinic, Inc.

  • General Acute Care Hospital
  • Montgomery, AL
  • NPI 1043262488
  Care Compare affiliation

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1396742318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 WILLIS AVE",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704273004",
            "telephone_number": "985-732-4853",
            "fax_number": "985-735-8883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 E SOUTH BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162501",
            "telephone_number": "334-420-5001",
            "fax_number": "334-420-0160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "712 Willis Ave",
            "address_purpose": "LOCATION",
            "city": "Bogalusa",
            "state": "LA",
            "postal_code": "704273004",
            "country_code": "US",
            "telephone_number": "985-732-4853",
            "fax_number": "985-735-8883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THERIAULT",
        "first_name": "VICTOR",
        "middle_name": "GASTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "014544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1181251",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Therapeutic Programs, Inc.
• Therapeutic Rewards
• Therapeutic Touches, LLC
• Therapy South - Carmichael Road LLC
• Therapy South - Montgomery LLC
• Sheena Patrice Thibodeaux
• Divya Mounisha Reddy Thimmareddygari, MD
• Thomas H. Williams III DMD, PC
• Sherika Lakesa Thomas-Miller, LPC
• Alesha Thomas, LMSW

• Family Medicine Physician in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.
• 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.