Thibodeaux Medical Clinic, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

THIBODEAUX MEDICAL CLINIC, LLC

Practice address

1303 Horridge St
Vinton, LA 70668-4531

Phone

(337) 324-8060

Fax

(337) 324-8061

NPI assigned

Sep 15, 2019

Last updated

Apr 21, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Derrick Thibodeaux, NPNPI 1659762839

Title

Nurse Practitioner

Phone

(337) 324-8060

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Derrick Thibodeaux, N.P.

  • Family Nurse Practitioner
  • Vinton, LA
  • NPI 1659762839
  Medicare reassignment Care Compare group NPD Authorized official
• Hanna Esthay Goodwin

  • Family Nurse Practitioner
  • Lake Charles, LA
  • NPI 1992538458
  Medicare reassignment Care Compare group NPD
• Bonnie Spellman, FNP-C

  • Nurse Practitioner
  • Lafayette, LA
  • NPI 1902689011

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Madison Theriot Lestage, FNP-C

  • Nurse Practitioner
  • Vinton, LA
  • NPI 1174468995
  Medicare reassignment NPD
• Lexus Louvier Martin, APRN, FNP-C

  • Family Nurse Practitioner
  • Sulphur, LA
  • NPI 1265090179

  Single Specialty

  NPD
• Micca R Riedel, ANP-C, GNP-BC

  • Adult Health Nurse Practitioner
  • Orange, TX
  • NPI 1538439385
  NPD (past)

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

{
    "created_epoch": "1568505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1689224321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 HORRIDGE ST",
            "city": "VINTON",
            "state": "LA",
            "postal_code": "706684531",
            "telephone_number": "337-324-8060",
            "fax_number": "337-324-8061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 HORRIDGE ST",
            "city": "VINTON",
            "state": "LA",
            "postal_code": "706684531",
            "telephone_number": "337-324-8060",
            "fax_number": "337-324-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIBODEAUX MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-15",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "THIBODEAUX",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "337-324-8060",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "thibodeauxmedicalclinic@gmail.com",
            "affiliation": "N",
            "address_1": "1303 Horridge St",
            "city": "Vinton",
            "state": "LA",
            "country_code": "US",
            "postal_code": "706684531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• St. Angela Merici Foundation
• St. Angela Merici Foundation
• St. Angela Merici Foundation
• St. Angela Merici Foundation
• Katherine Stephens
• Derrick Thibodeaux, N.P.
• Lance Waldmeier
• Valarie Philliber Waldmeier, PHD, APRN-BC, FNP, A

• Family Medicine Physician in Vinton, LA
• Providers in Vinton, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.