Individual provider Active NPI

Allison Kathryn Theberge, MD

  • Family Medicine Physician
  • Chula Vista, CA
National Provider Identifier
1023673241
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
178398 Issued in CA
Practice address
971 Lane Ave
Chula Vista, CA 91914-3501
Phone
(619) 502-7324
NPI assigned
May 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 178398 CA Primary

Addresses

Primary practice location

971 Lane Ave
Chula Vista, CA 91914-3501

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (619) 502-7324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220930000838 CA Practitioner - Family Practice 3678959525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Virginia School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

971 Lane Ave
Chula Vista, CA 91914-3501
Phone (619) 502-7300

Hospital & facility affiliations

  • Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
178398CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Family Medicine Current Accepting new patients
Scripps Health CurrentSince Oct 17, 2022 Accepting new patients
Scripps Health Family Medicine CurrentSince Oct 17, 2022 Accepting new patients
Scripps Health Past Accepting new patients

Locations

971 Lane Ave
Chula Vista, CA 91914
Phone (619) 472-1000

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1023673241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "619-502-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LANE AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143501",
            "telephone_number": "619-502-7324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEBERGE",
        "first_name": "ALLISON",
        "middle_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-02",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "178398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.