Individual provider Active NPI

Nicole Soudelier, FNP-BC

  • Nurse Practitioner
  • Thibodaux, LA
National Provider Identifier
1629701701
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
225948 Issued in LA
Practice address
604 N Acadia Rd Ste 101
Thibodaux, LA 70301-4897
Phone
(985) 446-5079
NPI assigned
Jul 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 225948 LA Primary

Addresses

Primary practice location

604 N Acadia Rd Ste 101
Thibodaux, LA 70301-4897

Mailing address

604 N Acadia Rd Ste 101
Thibodaux, LA 70301-4897

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
I20221109000616 LA Practitioner - Nurse Practitioner 9638546377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Louisiana Ear, Nose, and Throat Specialists, Inc.Group PAC ID 0042313504, 65 clinicians

Practice addresses (Care Compare)

604 N Acadia Rd
Suite 101
Thibodaux, LA 70301-4897
Phone 9854465079110

Hospital & facility affiliations

  • Thibodaux Regional Medical Center Hospital, Thibodaux, LA, CCN 190004
  • Terrebonne General Medical Center - Parish Hospital, Houma, LA, CCN 190008
  • Ochsner St Mary Hospital, Morgan City, LA, CCN 190014

Merit-based Incentive Payment System (MIPS)

Final score
60.95 of 100Reported as group
Quality
35.55
Promoting interoperability
88
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
225948LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Ear, Nose, & Throat Specialists, Inc. CurrentSince Aug 18, 2022 Accepting new patients
Lsuhn Billing LLC Past Accepting new patients
Start Corporation Past Accepting new patients

Locations

5040 W Main St
Ste 2
Houma, LA 70360
Phone (985) 446-5079

5040 W Main St
Houma, LA 70360
Phone (985) 446-5079

1231 Kenneth St
Morgan City, LA 70380
Phone (985) 384-9440

604 N Acadia Rd
Ste 101
Thibodaux, LA 70301
Phone (985) 446-5079

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1629701701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 N ACADIA RD STE 101",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 N ACADIA RD STE 101",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014897",
            "telephone_number": "985-446-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUDELIER",
        "first_name": "NICOLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "225948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.