Meredith Wade Thibodeaux, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

200668 Issued in LA

Practice address

1541 Kings Hwy
Shreveport, LA 71103-4228

Phone

(318) 675-4394

Fax

(318) 675-6186

NPI assigned

Sep 11, 2013

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

Other identifiers 1

Other names 1

• Meredith Ann Wade Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lsu Health Sciences Center Shreveport Faculty Group PracticeGroup PAC ID 4082902721, 567 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Lsu Health Shreveport-St Mary Medical Cent Hospital, Shreveport, LA, CCN 190317

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lno7389@yourcarecommunity.org

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.

• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222
  Medicare reassignment Care Compare group
• University Health Shreveport LLC

  • Nurse Practitioner
  • Shreveport, LA
  • NPI 1619443611

  Physician Assistant

  Medicare reassignment NPD
• Minden Physician Practices LLC

  • Multi-Specialty Clinic/Center
  • Minden, LA
  • NPI 1497986764
  Medicare reassignment
• Minden Physician Practices LLC

  • Rural Health Clinic/Center
  • Haughton, LA
  • NPI 1699392589
  NPD
• Minden Physician Practices LLC

  • Rural Health Clinic/Center
  • Minden, LA
  • NPI 1720360795
  NPD
• University Health Shreveport LLC

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
  • NPI 1629544622
  NPD
• Brfhh Shreveport LLC

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1912909912
  NPD (past)

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

• Ochsner Lsu Health Shreveport - St. Mary Medical Center, LLC

  • Women's Hospital
  • Shreveport, LA
  • NPI 1285253252
  Care Compare affiliation

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1811322605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 HOLOMON LOOP",
            "city": "DUBBERLY",
            "state": "LA",
            "postal_code": "710242747",
            "telephone_number": "318-564-8781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-4394",
            "fax_number": "318-675-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAUX",
        "first_name": "MEREDITH",
        "middle_name": "WADE",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-11",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "200668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2345290",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEREDITH",
            "last_name": "WADE",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Theres No Place Like Home Care
• Austin Michael Theriot, RPSS
• Pamela Elaine Theriot, O.D.
• Sindhu Thevuthasan
• Daphne Thibeaux
• Richard Seth Thibodeaux
• Christopher David Thiels, PHARM.D.
• Samantha Thiemann, PT, DPT
• Third Future Schools - Louisiana
• Todd Gary Thoma, M.D.

• Physician Assistant in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.