NICHOLLS STATE SPORTS MEDICINE
NPI 1861881435
Family Medicine in Thibodaux, LA

Q: What is Nicholls State University's NPI number?

The NPI number for Nicholls State University is 1861881435. It was assigned to this organization in the NPPES registry on January 20, 2015. The provider is doing business as Nicholls State Sports Medicine.

Q: What is Nicholls State University's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since January 20, 2015

906 E 1ST ST, THIBODAUX, LA 70301(985) 448-4837(972) 367-3451 Get Directions Write a Review

NPPES record last updated: January 20, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Nicholls State Sports Medicine NPPES

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

NICHOLLS STATE SPORTS MEDICINE (NPI 1861881435) is a healthcare organization registered as a family medicine in Thibodaux, Louisiana and active in the NPI registry since January 2015. The organization lists Mouzon Bass, Agent, as its authorized official.

NPPES Registry Identity

NPI1861881435

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameNICHOLLS STATE UNIVERSITY

Location Address906 E 1ST STThibodaux, LA 70301-6701

Mailing Address5050 Spring Valley RdDallas, TX 75244-3995 · (800) 555-9073 · Fax (972) 367-3452

Phone(985) 448-4837

Fax(972) 367-3451

Organization SubpartNo

Authorized OfficialMouzon BassAgent · 18005559073

Enumeration DateJanuary 20, 2015

✔ NPI 1861881435 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedFamily Medicine · Sports MedicineTaxonomy 207QS0010X

906 E 1ST ST, Thibodaux, LA 70301

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Other Names 1

Doing Business AsNicholls State Sports Medicine

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 10

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

LUKE JOSEPH FALGOUT

Student in an Organized Health Care Education/Training Program

906 E 1ST ST
THIBODAUX, LA 70301

Lafourche Parish (877) 642-4655

MAUREEN BROOKS ATC

Specialist/Technologist (Athletic Trainer)

906 E 1ST ST
THIBODAUX, LA 70301

Lafourche Parish (985) 448-4837

THE FOUNDATION FOR THE ADVANCEMENT OF A STRATEGIC SCIENCE OF TEACHING

Behavior Analyst

906 E 1ST ST
THIBODAUX, LA 70301

Lafourche Parish (985) 448-4321

RAEGAN WILLIS ATC

Specialist/Technologist (Athletic Trainer)

906 E 1ST ST
THIBODAUX, LA 70301

Lafourche Parish (985) 448-4507

MRS. REBECCA ANNE WOOD FNP

Nurse Practitioner (Family)

906 E 1ST ST
THIBODAUX, LA 70301

Lafourche Parish (985) 493-2600

JOSEPH FERKEL MS, ATC

Specialist/Technologist (Athletic Trainer)

906 E 1ST ST
THIBODAUX, LA 70301

Lafourche Parish (985) 448-4810

MR. TIMOTHY QUINTON NEASE II MS, LAT, ATC, CES

Specialist/Technologist (Athletic Trainer)

906 E 1ST ST, SPORTS MEDICINE-BASKETBALL
THIBODAUX, LA 70301

Lafourche Parish (912) 663-5841

BRADEN PATRICK JARRARD LAT, ATC, NREMT

Specialist/Technologist (Athletic Trainer)

906 E 1ST ST
THIBODAUX, LA 70301

Lafourche Parish (887) 642-4655

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 Nicholls State University's NPI number?

The NPI number for Nicholls State University is 1861881435. It was assigned to this organization in the NPPES registry on January 20, 2015. The provider is doing business as Nicholls State Sports Medicine.

Where is Nicholls State University located?

Nicholls State University is located at 906 E 1st St, Thibodaux, LA 70301. The listed phone number is (985) 448-4837.

What is Nicholls State University's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Nicholls State University was last updated on January 20, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.