Houma-Thibodaux Spine and Rehabilitation LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1380 Issued in LA

Legal business name

HOUMA-THIBODAUX SPINE AND REHABILITATION LLC

Practice address

430 Corporate Dr.
Houma, LA 70360

Phone

(985) 873-8586

Fax

(985) 873-8565

NPI assigned

Dec 20, 2006

Last updated

Apr 12, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Beau I. Porche, DCNPI 1285674325

Title

Owner

Phone

(985) 873-8586

Specialties & licenses 2

Addresses

Other names 1

• Thibodaux Injury & Rehabilitation Former legal business name

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 2

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.

• Beau Isaac Porche, D.C.

  • Chiropractor
  • Houma, LA
  • NPI 1285674325
  Medicare reassignment NPD Authorized official
• Ricky Charles Melancon, D.C.

  • Chiropractor
  • Houma, LA
  • NPI 1528069770
  NPD (past)

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460419200000",
    "number": "1891859500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 CORPORATE DR.",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "70360",
            "telephone_number": "985-873-8586",
            "fax_number": "985-873-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 CORPORATE DR.",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "70360",
            "telephone_number": "985-873-8586",
            "fax_number": "985-873-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUMA-THIBODAUX SPINE AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2016-04-12",
        "status": "A",
        "authorized_official_last_name": "PORCHE",
        "authorized_official_first_name": "BEAU",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-873-8586",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1380",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "LA",
            "license": "1380",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thibodaux Injury & Rehabilitation",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Houma Surgi-Center, Inc & Urology Clinic
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• Houma Urgent Care LLC
• Houma Wellness Center Counseling Services
• Houma-Amg Specialty Hospital, LLC
• House Rentals (Surgical & Hospital Supplies)
• Italia Houston
• Naquella K Howard, REGISTERED NURSE
• Narquisia Antoinette Howard
• Tanya Goff Howard, OT

• Chiropractor in Houma, LA
• Providers in Houma, LA by specialty
• Chiropractor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.