Sunny Q Thibodeaux, NURSE PRACTIONIER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN19160 Issued in TN

Practice address

1060 Peerless Xing NW Ste 101
Cleveland, TN 37312

Phone

(423) 479-4165

Fax

(423) 478-1884

NPI assigned

Jan 13, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Sunny Q Higgins Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TN, WA2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crossroads Urgent Care PLLCGroup PAC ID 8325117484, shared by 6 NPIs, 181 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Crossroads Urgent Care PLLC

  • Family Medicine Physician
  • Murfreesboro, TN
  • NPI 1366644361
  Medicare reassignment NPD
• DX Mso, PLLC

  • Urgent Care Clinic/Center
  • Chattanooga, TN
  • NPI 1225381148
  Medicare reassignment NPD
• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  Medicare reassignment NPD
• Grant County Public Hospital District 1

  • Rural Health Clinic/Center
  • Moses Lake, WA
  • NPI 1619086766
  Medicare reassignment NPD
• Crossroads Urgent Care PLLC

  • Rural Health Clinic/Center
  • South Pittsburg, TN
  • NPI 1427781129

  Family

  NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Grant County Public Hospital District 1

  • Rural Health Clinic/Center
  • Moses Lake, WA
  • NPI 1609112739
  NPD

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

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1427329044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 PEERLESS XING NW STE 101",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123784",
            "telephone_number": "423-479-4165",
            "fax_number": "423-478-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 PEERLESS XING NW STE 101",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "37312",
            "telephone_number": "423-479-4165",
            "fax_number": "423-478-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAUX",
        "first_name": "SUNNY",
        "middle_name": "Q",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTIONIER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-13",
        "last_updated": "2020-09-02",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN19160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sunny.thibodeaux.1@1525.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1060 Peerless Xing NW Ste 101",
            "city": "Cleveland",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37312",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sunny.thibodeaux.1@1525.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "1060 Peerless Xing NW Ste 101",
            "city": "Cleveland",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SUNNY",
            "last_name": "HIGGINS",
            "middle_name": "Q",
            "prefix": "MRS.",
            "credential": "NURSE PRACTIONIER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; 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.