Individual provider Active NPI

Courtney Marie Dufrene, PA-C

  • Physician Assistant
  • Thibodaux, LA
National Provider Identifier
1598598476
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
343676 Issued in LA
Practice address
602 N Acadia Rd
Thibodaux, LA 70301-4823
Phone
(985) 493-4993
NPI assigned
Aug 26, 2024
Last updated
Aug 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 343676 LA Primary

Addresses

Primary practice location

602 N Acadia Rd
Thibodaux, LA 70301-4823

Mailing address

1005 Ethel St
Lockport, LA 70374-2831
Phone (985) 258-9088

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250121003048 LA Practitioner - Physician Assistant 7517496565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2595 Hwy 1
Labadieville, LA 70372
Phone (985) 493-4993

602 N Acadia Rd
Thibodaux, LA 70301-4823

602 N Acadia Rd
Thibodaux, LA 70301-4847

608 N Acadia Rd
Thibodaux, LA 70301-4847

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
343676LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Thibodaux Regional Network Development Corporation Current Accepting new patients
Thibodaux Regional Network Development Corporation CurrentSince Nov 1, 2024 Accepting new patients
Thibodaux Regional Network Development Corporation CurrentSince Nov 1, 2024 Accepting new patients
Thibodaux Regional Network Development Corporation Past Accepting new patients

Locations

602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1598598476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 ETHEL ST",
            "city": "LOCKPORT",
            "state": "LA",
            "postal_code": "703742831",
            "telephone_number": "985-258-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 N ACADIA RD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014823",
            "telephone_number": "985-493-4993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFRENE",
        "first_name": "COURTNEY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "343676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.