NPIMap

Organization Active NPI

Thibodaux Regional Network Development Corporation

Doing business as Thibodaux Regional Pulmonology & Critical Care Clinic

  • Pulmonary Disease Physician
  • Thibodaux, LA
National Provider Identifier
1801136023
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Doing business as
Thibodaux Regional Pulmonology & Critical Care Clinic
Practice address
604 N Acadia Rd
Ste 411
Thibodaux, LA 70301-4851
Phone
(985) 493-4933
Fax
(985) 493-4934
NPI assigned
Feb 25, 2013
Last updated
Jun 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Authorized official

Name
Kim Legendre Boudreaux
Title
Contract Manager
Phone
(985) 493-4907

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X
Pulmonary Disease Physician 207RP1001X Primary

Addresses

Primary practice location

604 N Acadia Rd
Ste 411
Thibodaux, LA 70301-4851

Mailing address

PO Box 5478
Thibodaux, LA 70302-5478
Phone (985) 493-4933

Other identifiers 1

IdentifierTypeStateIssuer
2336673MedicaidLA

Other names 1

  • Thibodaux Regional Pulmonology & Critical Care Clinic Doing business as

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

Other organizations with this tax ID 26

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

View all 26

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748822400000",
    "number": "1801136023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5478",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703025478",
            "telephone_number": "985-493-4933",
            "fax_number": "985-493-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 N ACADIA RD",
            "address_2": "STE 411",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014851",
            "telephone_number": "985-493-4933",
            "fax_number": "985-493-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-25",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A",
        "authorized_official_last_name": "BOUDREAUX",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "LEGENDRE",
        "authorized_official_title_or_position": "CONTRACT MANAGER",
        "authorized_official_telephone_number": "985-493-4907"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2336673",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thibodaux Regional Pulmonology & Critical Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 2, 2025; 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.