Allecia Thibeault, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209013081 Issued in IL

Practice address

2208 W Willow Knolls Dr
Peoria, IL 61614-1467

Phone

(309) 693-9600

Fax

(309) 693-3616

NPI assigned

Aug 17, 2015

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

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: athibeault21432@azacp.direct-ci.com

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.

• Arizona Community Physicians PC

  • Internal Medicine Physician
  • Tucson, AZ
  • NPI 1205871076

  Nurse Practitioner

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AZ, Nurse Practitioner

  Medicare reassignment NPD
• TMC Medical Network

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1750832283
  Medicare reassignment NPD
• TMC Urgent Care

  • Urgent Care Clinic/Center
  • Tucson, AZ
  • NPI 1649759606
  Medicare reassignment NPD
• Arizona Community Physician PC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Tucson, AZ
  • NPI 1922141902
  NPD
• TMC Urgent Care

  • Urgent Care Clinic/Center
  • Tucson, AZ
  • NPI 1669202909
  NPD

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1548636327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31235",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857511235",
            "telephone_number": "172-752-0324",
            "fax_number": "520-324-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 W WILLOW KNOLLS DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141467",
            "telephone_number": "309-693-9600",
            "fax_number": "309-693-3616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10350 E Drexel Rd Unit 110",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857479409",
            "country_code": "US",
            "telephone_number": "520-324-1727",
            "fax_number": "520-324-1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3900 N Sabino Canyon Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857502130",
            "country_code": "US",
            "telephone_number": "520-324-1301",
            "fax_number": "520-324-1345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10350 E Drexel Rd Unit 170",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857479411",
            "country_code": "US",
            "telephone_number": "520-324-8070",
            "fax_number": "520-324-8071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2424 N Wyatt Dr Ste 140",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857126115",
            "country_code": "US",
            "telephone_number": "520-324-4690",
            "fax_number": "520-324-4691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THIBEAULT",
        "first_name": "ALLECIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209013081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Loft Rehabilitation of Peoria LLC
• The Plaid Daisy Inc
• The Sanction Community Outreach
• Jacey Melissa Thelen
• Melissa M Theobald, FNP
• Megan Thibodeau, APN
• Mackinze Thill, LPC
• Thomas C. Ferlmann DMD , PC
• Thomas F Kouri Internal Medicine Inc
• Ashley Thomas, MS, RD/LDN

• Nurse Practitioner in Peoria, IL
• Providers in Peoria, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.