Kaleb M Thibodeaux, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

239936 Issued in LA

Practice address

203 Allendale Dr
Port Allen, LA 70767-3219

Phone

(225) 389-1311

Fax

(225) 389-1330

NPI assigned

Mar 6, 2025

Sex

Male

Sole proprietor

No

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

Enrolled in LA

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 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primary Care Providers for a Healthy Feliciana, IncGroup PAC ID 1052220985, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kaleb.thibodeaux.p1@direct.rkmprimarycare.nextgenshare.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.

• Primary Care Providers for a Healthy Feliciana, Inc.

  dba Clinton Lower Health Center

  • Federally Qualified Health Center (FQHC)
  • Clinton, LA
  • NPI 1821245127
  Medicare reassignment Care Compare group NPD
• Primary Care Providers for a Healthy Feliciana, Inc

  dba RKM Primary Care Baton Rouge

  • Federally Qualified Health Center (FQHC)
  • Baton Rouge, LA
  • NPI 1134884323
  NPD
• Primary Care Providers for a Healthy Feliciana, Inc

  dba RKM at Springfield Elementary

  • Federally Qualified Health Center (FQHC)
  • Springfield, LA
  • NPI 1326923384
  NPD

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

{
    "created_epoch": "1741219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1508664293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 395",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707220395",
            "telephone_number": "225-683-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 ALLENDALE DR",
            "city": "PORT ALLEN",
            "state": "LA",
            "postal_code": "707673219",
            "telephone_number": "225-389-1311",
            "fax_number": "225-389-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAUX",
        "first_name": "KALEB",
        "middle_name": "M",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "239936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stevens Pharmacy Inc (Stevens Pharmacy)
• Chandra Charlita Stewart
• Sarah Stickley
• Dennis L. Surratt, O.D.
• SWC West Baton Rouge, LLC (Medical Spine, Spine & Sports of WBR)
• Totally Into You Counseling and Consulting
• Bethany Toups, LCSW-BACS
• Deborah Ann Treuil, RN
• Trinity Behavioral Health of Port Allen
• Unbreakable Counseling and Consulting

• Psychiatric/Mental Health Nurse Practitioner in Port Allen, LA
• Providers in Port Allen, LA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.