McKenna Nicole Thibodeau, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

19582 Beach Blvd Ste 130
Huntington Beach, CA 92648-5924

Phone

(714) 841-6162

NPI assigned

Jul 8, 2024

Last updated

Jul 8, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cuirim Sports Physical Therapy IncGroup PAC ID 4082027537, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cuirim Sports Physical Therapy Inc

  dba Cuirim Sports Recovery

  • Physical Therapist
  • Costa Mesa, CA
  • NPI 1801435193
  Medicare reassignment Care Compare group NPD
• Proactive Physical Therapy & Sports Medicine Inc

  • Physical Therapy Clinic/Center
  • Carlsbad, CA
  • NPI 1285729509

  Physical Therapist

  Medicare reassignment NPD
• DPT Holdings, LLC

  dba Doctors of Physical Therapy

  • Physical Therapist
  • Plainfield, IL
  • NPI 1689648602
  NPD (past)

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1790521904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 ROCHESTER AVE APT B",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926483154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19582 BEACH BLVD STE 130",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926485924",
            "telephone_number": "714-841-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAU",
        "first_name": "MCKENNA",
        "middle_name": "NICOLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Yard
• Theo Pharmaceuticals, Inc (MDRx Compounding Pharmacy)
• Thera Ready, LLC
• Therapy Bubble: Speech Language Pathology Services Corp
• Therapy on Demand Inc
• Thomas a. Goodheart M.D., Inc.
• Thomas F Besley MD Inc
• Casey Thomas, RD
• Hayley Alyssa Thomas, DC
• John Thomas, CMT

• Physical Therapist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.