NICHOLAS JOHN THIBAULT PA-C NPI 1043612070

NPI Information

  • NPI: 1043612070
  • Provider Name: NICHOLAS JOHN THIBAULT, PA-C
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • Address: 141 REGATTA WAY
    SNEADS FERRY, NC
    ZIP 28460
  • Phone: (219) 689-8493

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NPI Details

Nicholas John Thibault, PA-C is a medical physician assistant in Sneads Ferry, NC. Nicholas John Thibault, PA-C NPI is 1043612070. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

141 REGATTA WAY
SNEADS FERRY, NC
ZIP 28460-100
Phone: (219) 689-8493

The enumeration date for this NPI number is 9/22/2014 and was last updated on 3/24/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalCALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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