Active NPI
Kim Thibodeaux Belanger, PD
- Pharmacist
- Houma, LA
National Provider Identifier
1740510684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11851
- Practice address
- 106 Lynwood Dr
Houma, LA 70360-6224 - Phone
- (985) 851-1639
- NPI assigned
- Dec 26, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11851 | LA | Primary |
Addresses
Primary practice location
106 Lynwood Dr
Houma, LA 70360-6224
Mailing address
106 Lynwood Dr
Houma, LA 70360-6224
Phone (985) 851-1639
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11851 | Other | LA | PHARMACIST LICENSE |
Other names 1
- Kim Elizabeth Thibodeaux
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11851 | LA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261785600000",
"number": "1740510684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 LYNWOOD DR",
"city": "HOUMA",
"state": "LA",
"postal_code": "703606224",
"telephone_number": "985-851-1639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 LYNWOOD DR",
"city": "HOUMA",
"state": "LA",
"postal_code": "703606224",
"telephone_number": "985-851-1639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELANGER",
"first_name": "KIM",
"middle_name": "THIBODEAUX",
"credential": "PD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-26",
"last_updated": "2009-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "11851",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "11851",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KIM",
"last_name": "THIBODEAUX",
"middle_name": "ELIZABETH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Houma, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.