Jasmaine Theobald, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3009523 Issued in KY

Practice address

2601 Kentucky Ave
Suite 103
Paducah, KY 42003-3817

Phone

(270) 415-4860

Fax

(270) 415-4862

NPI assigned

Jul 14, 2015

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

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Health Medical Group IncGroup PAC ID 5597867184, shared by 31 NPIs, 2,431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Paducah Hospital, Paducah, KY, CCN 180104

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jvincent40392@bhkydirect.com

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.

• Baptist Health Medical Group Inc

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1922401611
  Medicare reassignment NPD
• Baptist Health Medical Group Inc

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  Medicare reassignment NPD
• GLK Enterprises, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Brownsville, KY
  • NPI 1912912734
  Medicare reassignment NPD
• Baptist Health Medical Group Inc

  • Rural Health Clinic/Center
  • Powderly, KY
  • NPI 1477048684
  NPD

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

• Baptist Healthcare System, Inc

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1730264128
  Care Compare affiliation

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

{
    "created_epoch": "1436832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1346624962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 STANLEY GAULT PKWY STE 129",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235176",
            "telephone_number": "502-253-4900",
            "fax_number": "502-489-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 KENTUCKY AVE",
            "address_2": "SUITE 103",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033817",
            "telephone_number": "270-415-4860",
            "fax_number": "270-415-4862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "543 Powell Ln",
            "address_purpose": "LOCATION",
            "city": "Benton",
            "state": "KY",
            "postal_code": "420255366",
            "country_code": "US",
            "telephone_number": "270-415-7070",
            "fax_number": "270-415-7071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4754 US Highway 62",
            "address_purpose": "LOCATION",
            "city": "Calvert City",
            "state": "KY",
            "postal_code": "420298456",
            "country_code": "US",
            "telephone_number": "270-415-7780",
            "fax_number": "270-415-7779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THEOBALD",
        "first_name": "JASMAINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-14",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3009523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100390020",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Ophthalmology Group, LLC
• The Ophthalmology Group, LLC
• The Paducah Orthopaedic Clinic
• The Skin Institute PLLC
• The Weights and Plates Rd LLC
• Adrian G Thodoropoulos, CRNA
• Jenna Danelle Thomas-Roberts
• Alyson R Thomas, PMHNP
• Darrin D Thomas
• Derick Thomas, PA-C

• Family Nurse Practitioner in Paducah, KY
• Providers in Paducah, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.