NPIMap

Organization Active NPI

Thibodaux Regional Network Development Corporation

  • Clinical Cardiac Electrophysiology Physician
  • Thibodaux, LA
National Provider Identifier
1770435851
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
Legal business name
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Practice address
602 N Acadia Rd
Ste 101B
Thibodaux, LA 70301
Phone
(985) 493-4938
Fax
(985) 449-2547
NPI assigned
Feb 11, 2026
Last updated
Feb 11, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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

Authorized official

Name
Kim Legendre Boudreaux
Title
Director of Contracting
Phone
(985) 493-4907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X Primary

Addresses

Primary practice location

602 N Acadia Rd
Ste 101B
Thibodaux, LA 70301

Mailing address

602 N Acadia Rd
Contract Management Dept.
Thibodaux, LA 70301
Phone (985) 493-4907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040608000132 LA Part B Supplier - Clinic/Group Practice 8224011754 Receives reassigned benefits from 181 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Thibodaux, LA; Vacherie, LA; Houma, LA; Labadieville, LA; Paincourtville, LA; Pierre Part, LA; Raceland, LA

Other NPIs on the same Medicare enrollment 37

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 37

National Provider Directory

National Provider Directory
Tax ID family
Thibodaux Regional Network Development Corporation27 organizations share this tax ID, including this one
Part of
Thibodaux Regional Network Development Corporation

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Locations

290 Bowie Rd
Thibodaux, LA 70301
Phone (985) 493-4782

506 N Acadia Rd
Ste B
Thibodaux, LA 70301
Phone (985) 493-4087

602 N Acadia Rd
Ste 101B
Thibodaux, LA 70301
Phone (985) 493-4938

726 N Acadia Rd
Ste 2300
Thibodaux, LA 70301
Phone (985) 493-3090

726 N Acadia Rd
Ste 2400
Thibodaux, LA 70301
Phone (985) 493-4080

Practitioners & affiliated clinicians

Practitioners 170

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.

View all 170

NPI Registry JSON

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

{
    "created_epoch": "1770768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770768000000",
    "number": "1770435851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 N ACADIA RD",
            "address_2": "CONTRACT MANAGEMENT DEPT.",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "70301",
            "telephone_number": "985-493-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 N ACADIA RD",
            "address_2": "STE 101B",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "70301",
            "telephone_number": "985-493-4938",
            "fax_number": "985-449-2547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION",
        "enumeration_date": "2026-02-11",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A",
        "authorized_official_last_name": "BOUDREAUX",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "LEGENDRE",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTING",
        "authorized_official_telephone_number": "985-493-4907"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.