LARA CORNELIA THIBODEAUX (NP) – Family Nurse Practitioner, NPI 1902894595
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
Provider Addresses for LARA CORNELIA THIBODEAUX (NP)
1500, University Drive East, College Station, Brazos County, Texas, 77840, United States
SUITE 100
COLLEGE STATION, TX 778402600
Phone: (979) 846-1100
Fax: (979) 260-9390
Type: Mailing
808 W US HIGHWAY 79
2880
FRANKLIN, TX 77856
Phone: (979) 282-4540
Fax: (979) 828-3006
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 29 Open Payments records for all available years, with a total value of $480.
Total Amount is formed as General ($480) + Research ($0) + Ownership ($0) = $480.
Last reported payment date: 2024-12-09 • Largest payer in this snapshot: Novo Nordisk Inc ($358).
Total Amount
$480
General + Research + Ownership
Payments
29
Total payment records
General Amount
$480
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $358 |
| Merck Sharp & Dohme LLC | $40 |
| Lilly USA, LLC | $31 |
| Abbott Laboratories | $23 |
| United Therapeutics Corporation | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-11-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041117001019 | I | Nurse Practitioner | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 77840)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX | |
| Family Practice | TX | |
| Nurse Practitioner | TX | |
| Clinical Social Worker | WA | |
| Nurse Practitioner | TX | |
| - | TX | |
| Physician Assistant | TX | |
| Family Practice | TX | |
| Family Practice | TX | |
| - | TX |
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