THAILA KEODOUANGDY
NPI 1104448919
Nurse Practitioner - Family in Citronelle, AL

Active since May 14, 2020PECOS EnrolledAccepts Medicare Assignment
19250 N MOBILE ST, CITRONELLE, AL 36522(251) 866-9126 Get Directions Write a Review

NPPES record last updated: November 18, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 18, 2021, Jul 26, 2021, May 14, 2020 (3 updates tracked since 2020).

About Thaila Keodouangdy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THAILA KEODOUANGDY (NPI 1104448919) is an individual family provider in Citronelle, Alabama, licensed in Alabama (1-136625) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS, maintains a secondary practice location in Mobile, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1104448919
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameTHAILA KEODOUANGDY
Location Address19250 N MOBILE STCitronelle, AL 36522-2122
Mailing AddressPo Box 2867Mobile, AL 36652-2867 · (251) 690-8158
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateMay 14, 2020
Last NPPES UpdateNovember 18, 20213 updates tracked since enumeration
NPPES CertifiedNovember 18, 2021
NPI 1104448919 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in AL · 1-136625
19250 N MOBILE ST, Citronelle, AL 36522

Secondary Practice Location 1

Location 1251 N Bayou StMobile, AL 36603-5827 · Phone (251) 690-8158

Other Identifiers 1

Medicaid261555AL

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Thaila Keodouangdy is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991116451
PECOS Enrollment IDI20201204001933
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36522 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Federally Qualified Health Center (FQHC))
19250 N MOBILE ST
CITRONELLE, AL 36522
Dentist (General Practice)
19250 N MOBILE ST
CITRONELLE, AL 36522
Nurse Practitioner (Primary Care)
19250 N MOBILE ST
CITRONELLE, AL 36522
Nurse Practitioner (Family)
19250 N MOBILE ST
CITRONELLE, AL 36522

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thaila Keodouangdy's NPI number?

The NPI number for Thaila Keodouangdy is 1104448919. It was assigned to this individual provider in the NPPES registry on May 14, 2020.

Where is Thaila Keodouangdy located?

Thaila Keodouangdy practices at 19250 N Mobile St, Citronelle, AL 36522. The listed phone number is (251) 866-9126.

What is Thaila Keodouangdy's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Thaila Keodouangdy enrolled in Medicare?

Yes. Thaila Keodouangdy is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Thaila Keodouangdy accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama, Ambetter of Tennessee and Blue Cross and Blue Shield of Alabama and 1 other insurer list Thaila Keodouangdy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Thaila Keodouangdy was last updated on November 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.