Kandice Marie Thibodeaux

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD.207913 Issued in LA

Practice address

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917

Phone

(337) 470-4605

Fax

(337) 470-4595

NPI assigned

May 30, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lourdes Physician Group LLCGroup PAC ID 7214177757, 157 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lourdes Home Health Home health agency, Lafayette, LA, CCN 197057
• Our Lady of Lourdes Regional Medical Center, Inc Hospital, Lafayette, LA, CCN 190102
• Acadian Medical Center Hospital, Eunice, LA, CCN 190318

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lourdes Physician Group LLC

  • Family Medicine Physician
  • Lafayette, LA
  • NPI 1437405883
  Medicare reassignment Care Compare group NPD
• Lourdes After Hours LLC

  • Urgent Care Clinic/Center
  • Lafayette, LA
  • NPI 1649297730
  Medicare reassignment NPD
• Lourdes After Hours LLC

  • Urgent Care Clinic/Center
  • Carencro, LA
  • NPI 1669774923
  NPD
• Our Lady of Lourdes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1598766495
  NPD (past)

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

• CLHG-Acadian, LLC

  • General Acute Care Hospital
  • Eunice, LA
  • NPI 1396394961
  Care Compare affiliation
• LHCG Xiii, LLC

  • Home Health Agency
  • Lafayette, LA
  • NPI 1598829129
  Care Compare affiliation
• Our Lady of Lourdes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1598766495
  Care Compare affiliation

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1740541309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086917",
            "telephone_number": "337-470-2605",
            "fax_number": "337-470-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086917",
            "telephone_number": "337-470-4605",
            "fax_number": "337-470-4595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAUX",
        "first_name": "KANDICE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "LA",
            "license": "207913",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.207913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kthibodeaux68468@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kthibodeaux68468@direct.casso.us.com",
            "address_1": "4801 Ambassador Caffery Pkwy",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705086917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4801 Ambassador Caffery Pkwy",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705086917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Darline Marie Thibodeaux, MS CCC SLP
• Elizabeth C Thibodeaux, LCSW
• Jeffrey J Thibodeaux, MD
• Jemeka Thibodeaux
• Kaitlyn Moreau Thibodeaux, MS, LPC
• Katherine Prince Thibodeaux
• Kelly Thibodeaux
• Kerry Thibodeaux, LPC
• Lindsay Thibodeaux
• Loren Christian Thibodeaux, AU.D.

• Internal Medicine Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; 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.