JASMAINE THEOBALD APRN NPI 1346624962

NPI Information

  • NPI: 1346624962
  • Provider Name: JASMAINE THEOBALD, APRN
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2601 KENTUCKY AVE
    SUITE 103
    PADUCAH, KY
    ZIP 42003
  • Phone: (270) 415-4860

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NPI Details

Jasmaine Theobald, APRN is a family nurse practitioner in Paducah, KY with 10 years of experience. Jasmaine Theobald, APRN NPI is 1346624962. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2601 KENTUCKY AVE
SUITE 103
PADUCAH, KY
ZIP 42003-817
Phone: (270) 415-4860
Fax: (270) 415-4862

The NPI 1346624962 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Automated urinalysis test (HCPCS:81003)
  • Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza (HCPCS:87428)

The enumeration date for this NPI number is 7/14/2015 and was last updated on 12/3/2019.

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
1363LF0000XNurse PractitionerFamily3009523KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17100390020MEDICAIDKANSAS

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: 3/30/2025

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