Active NPI
Refresh Vitalis Health LLC
- Psychiatric/Mental Health Nurse Practitioner
- Carencro, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- REFRESH VITALIS HEALTH LLC
- Practice address
- 3419 NW Evangeline Trwy Ste a-5
Carencro, LA 70520-6241 - Phone
- (337) 520-2587
- Fax
- (337) 520-2594
- NPI assigned
- Mar 13, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tiffany Sampy Thibodeaux, FNP-C, PMHNP-BC
- Title
- Owner
- Phone
- (337) 520-2587
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
3419 NW Evangeline Trwy Ste a-5
Carencro, LA 70520-6241
Mailing address
3419 NW Evangeline Trwy Ste a-5
Carencro, LA 70520-6241
Phone (337) 520-2587
Other practice location 1
159 W Broadway Ste 200
Salt Lake City, UT 84101-1923
Phone (385) 449-3542
National Provider Directory
National Provider DirectoryLocations
3419 NW Evangeline Trwy
Ste A5
Carencro, LA 70520
Phone (337) 520-2587
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Carencro, LA
- NPI 1265887012
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773360000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1784246400000",
"number": "1881541373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3419 NW EVANGELINE TRWY STE A-5",
"city": "CARENCRO",
"state": "LA",
"postal_code": "705206241",
"telephone_number": "337-520-2587",
"fax_number": "337-520-2594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3419 NW EVANGELINE TRWY STE A-5",
"city": "CARENCRO",
"state": "LA",
"postal_code": "705206241",
"telephone_number": "337-520-2587",
"fax_number": "337-520-2594"
}
],
"practiceLocations": [
{
"address_1": "159 W Broadway Ste 200",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841011923",
"country_code": "US",
"telephone_number": "385-449-3542",
"fax_number": "385-449-3544",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "REFRESH VITALIS HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-03-13",
"last_updated": "2026-07-17",
"certification_date": "2026-07-17",
"status": "A",
"authorized_official_last_name": "THIBODEAUX",
"authorized_official_first_name": "TIFFANY",
"authorized_official_middle_name": "SAMPY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "337-520-2587",
"authorized_official_credential": "FNP-C, PMHNP-BC"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carencro, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.