NPIMap

Individual provider Active NPI

Lara Cornelia Thibodeaux, NP

  • Family Nurse Practitioner
  • Franklin, TX
National Provider Identifier
1902894595
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
593517 Issued in TX
Practice address
808 W US Highway 79
2880
Franklin, TX 77856
Phone
(979) 282-4540
Fax
(979) 828-3006
NPI assigned
Oct 8, 2005
Last updated
Feb 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 593517 TX Primary

Addresses

Primary practice location

808 W US Highway 79
2880
Franklin, TX 77856

Mailing address

1500 University Dr E
Suite 100
College Station, TX 77840-2600
Phone (979) 846-1100

Other identifiers 3

IdentifierTypeStateIssuer
1841562451OtherTXFACILITY NPI (SJHP FRANKLIN)
2952517-01OtherTXBVCAA DBA ST,. JOSEPH HEALTH POINT FRANKLIN MEDICAID (PTAN) NUMBER
67-1981OtherTXBVCAA DBA: ST. JOSEPH HEALTH POINT FRANKLIN PTAN (MEDICARE NUMBER)

Other names 1

  • Lara Cornelia Boyett Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041117001019 TX Practitioner - Nurse Practitioner 4789648825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

808 W US Hwy 79
Franklin, TX 77856-1728
Phone (979) 383-2340

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brazos Valley Community Action Agency, Inc. CurrentSince Jul 21, 2024 Accepting new patients
Brazos Valley Community Action Agency, Inc. CurrentSince Jul 21, 2024 Accepting new patients
Rapidcare Clinic PA Past Accepting new patients
Brazos Emergency Physicians, PA Past Accepting new patients
Traditions Emergency Medicine PA Past Accepting new patients
Brazos Valley Community Action Agency, Inc. Past Accepting new patients
Jonathan a. Friedman, M.D., PLLC Past Accepting new patients
St Joseph Physician Associates Past Accepting new patients

Locations

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

3370 S Texas Ave
Bryan, TX 77802
Phone (979) 595-1700

1500 University Dr E
College Station, TX 77840
Phone (979) 693-7400

1500 University Dr E
Ste 100
College Station, TX 77840
Phone (979) 383-2340

808 W US Highway 79
Franklin, TX 77856
Phone (979) 383-2340

808 W US Highway 79
#2880
Franklin, TX 77856
Phone (979) 282-4540

8310 Highway 6 Loop
Navasota, TX 77868
Phone (936) 825-0000

Interoperability endpoints

  • Direct secure messaging: lara.boyett@hptx.eclinicaldirectplus.com

Organizations & group practices 8

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1128729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1902894595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 UNIVERSITY DR E",
            "address_2": "SUITE 100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778402600",
            "telephone_number": "979-846-1100",
            "fax_number": "979-260-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 W US HIGHWAY 79",
            "address_2": "2880",
            "city": "FRANKLIN",
            "state": "TX",
            "postal_code": "77856",
            "telephone_number": "979-282-4540",
            "fax_number": "979-828-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAUX",
        "first_name": "LARA",
        "middle_name": "CORNELIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-08",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "593517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY NPI (SJHP FRANKLIN)",
            "identifier": "1841562451",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BVCAA DBA ST,. JOSEPH HEALTH POINT FRANKLIN MEDICAID (PTAN) NUMBER",
            "identifier": "2952517-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BVCAA DBA: ST. JOSEPH HEALTH POINT FRANKLIN PTAN (MEDICARE NUMBER)",
            "identifier": "67-1981",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARA",
            "last_name": "BOYETT",
            "middle_name": "CORNELIA",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Franklin, TX

Sources for this page

Verify at the official NPI Registry.