NPIMap

Organization Active NPI

Thibodaux Orthopaedic and Sports Medicine Clinic

  • Specialist
  • Thibodaux, LA
National Provider Identifier
1922194232
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
013892
Legal business name
THIBODAUX ORTHOPAEDIC AND SPORTS MEDICINE CLINIC
Practice address
525 Saint Mary St
Thibodaux, LA 70301-2627
Phone
(985) 446-6284
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Authorized official

Name
Neil J Maki, M.D.
Title
President
Phone
(985) 446-6284

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 013892 Primary

Addresses

Primary practice location

525 Saint Mary St
Thibodaux, LA 70301-2627

Mailing address

525 Saint Mary St
Thibodaux, LA 70301-2627
Phone (985) 446-6284

Other identifiers 1

IdentifierTypeStateIssuer
1446611MedicaidLA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1922194232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 SAINT MARY ST",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703012627",
            "telephone_number": "985-446-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 SAINT MARY ST",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703012627",
            "telephone_number": "985-446-6284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIBODAUX ORTHOPAEDIC AND SPORTS MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "MAKI",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "985-446-6284",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": "013892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1446611",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.