Allison McKenzie Theobald, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

3012345 Issued in KY

Practice address

6500 Preston Hwy
Louisville, KY 40219-1820

Phone

(502) 893-5502

NPI assigned

Oct 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Norton Children'S Medical Group, LLC

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1457999096

  Pediatrics

  Medicare reassignment NPD
• Norton Children'S Medical Group, LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Louisville, KY
  • NPI 1205477833

  Pediatrics

  NPD
• Norton Children'S Medical Group, LLC

  • Pediatric Radiology Physician
  • Louisville, KY
  • NPI 1659913812
  NPD
• Norton Childrens Medical Group, LLC

  • Pediatrics Physician
  • Louisville, KY
  • NPI 1326695255
  NPD (past)

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1083180905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 PRESTON HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402191820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 PRESTON HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402191820",
            "telephone_number": "502-893-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOBALD",
        "first_name": "ALLISON",
        "middle_name": "MCKENZIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-18",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KY",
            "license": "3012345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "atheobald63267@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "6500 Preston Hwy",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402191820",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6500 Preston Hwy",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402191820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael D Thedford
• Matthew Theilmann
• Michelle Theis, APRN
• Lauren Theiss, LPCC
• Jessica Thelen
• Theodore M Wandzilak MD
• Cristiane Carroll Theodoro
• Therabilities LLC
• Therapeds Pediatric Physical Therapy Inc.
• Therapeutic Alliance of Louisville LLC

• Pediatric Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Pediatric Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.