| Derrick Thibodeaux, NP | |
|
1303 Horridge St, Vinton, LA 70668-4531 | |
| (337) 324-8060 | |
| (337) 324-8061 |
| Full Name | Derrick Thibodeaux |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 12 Years |
| Location | 1303 Horridge St, Vinton, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659762839 | NPI | - | NPPES |
| AP08118 | Other | LA | LOUISIANA STATE BOARD OF NURSING |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | AP08118 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Southern Home Health | Lake charles, LA | Home health agency |
| West Calcasieu Cameron Hospital | Sulphur, LA | Hospital |
| Lake Charles Memorial Hospital | Lake charles, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Thibodeaux Medical Clinic, Llc | 2365774189 | 2 |
| Entity Name | Calcasieu Urgent Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467715490 PECOS PAC ID: 5496908071 Enrollment ID: O20130109000768 |
| Entity Name | Sound Physicians Emergency Medicine Of Louisiana Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396253407 PECOS PAC ID: 1759642739 Enrollment ID: O20180308001149 |
| Entity Name | Kisatchie Emergency Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235693847 PECOS PAC ID: 9537400270 Enrollment ID: O20190408001290 |
| Entity Name | Thibodeaux Medical Clinic, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689224321 PECOS PAC ID: 2365774189 Enrollment ID: O20191029000957 |
| Mailing Address | Practice Location Address |
|---|---|
| Derrick Thibodeaux, NP 1303 Horridge St, Vinton, LA 70668-4531 Ph: (337) 324-8060 | Derrick Thibodeaux, NP 1303 Horridge St, Vinton, LA 70668-4531 Ph: (337) 324-8060 |
Alexis Elizabeth Juneau, APRN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1611 Hampton St, Vinton, LA 70668 Phone: 337-589-5951 Fax: 337-589-4013 | |
Lance Waldmeier, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1611 Hampton St, Vinton, LA 70668 Phone: 337-589-5951 Fax: 337-589-4031 | |
Valarie Philliber Waldmeier, PHD, APRN-BC, FNP, A Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1611 Hampton St, Vinton, LA 70668 Phone: 337-475-5824 Fax: 337-475-5702 |