Kelly Thibodeaux, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP08412 Issued in LA

Practice address

2600 Belle Chasse Hwy # B2
Terrytown, LA 70056-7156

Phone

(504) 349-2273

NPI assigned

Jul 6, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• WJH Physician Services

  • Internal Medicine Physician
  • Marrero, LA
  • NPI 1417966193
  NPD (past)
• Peacehealth

  dba PeaceHealth Medical Group

  • Surgery Physician
  • Vancouver, WA
  • NPI 1609061969
  NPD (past)

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1639552979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 BELLE CHASSE HWY # B2",
            "city": "TERRYTOWN",
            "state": "LA",
            "postal_code": "700567156",
            "telephone_number": "504-349-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 BELLE CHASSE HWY # B2",
            "city": "TERRYTOWN",
            "state": "LA",
            "postal_code": "700567156",
            "telephone_number": "504-349-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAUX",
        "first_name": "KELLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-06",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP08412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AP08412",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tailored Care Inc
• Rance Templet, BC-HIS
• Ryan Troy Templet Jr., HIS
• Courtney Termine
• The Great Atlantic and Pacific Tea Company Inc (Sav a Center Pharmacy)
• Kisha Marie Thomas
• Joseph C Thompson, M.D.
• Marilyn McClelland Thorpe, PH.D.
• Jessica Cedotal Tiblier, PA-C
• Titan Management Services (Maxima Home Health)

• Family Nurse Practitioner in Terrytown, LA
• Providers in Terrytown, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.