Janeen M Theobald, ARNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

ARNP3359822 Issued in FL

Practice address

12902 Usf Magnolia Dr
Tampa, FL 33612

Phone

(813) 745-4673

NPI assigned

Feb 2, 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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1356731194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 HARBOUR WALK RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025971",
            "telephone_number": "321-626-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33612",
            "telephone_number": "813-745-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOBALD",
        "first_name": "JANEEN",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-02",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP3359822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014258500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "P01655871",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y0R2X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Thomas Theiling
• Deztiny Theirse
• Alexandra Thelan, PHD
• Remington Thele, RN
• Camille Suzanne Thelin, M.D.
• Robert James Theobald III, DO
• Theodore Edward David Peters, DDS,PA
• Margaret Theodore, M.D.
• Dorothy Theogene, DDS
• Christine Theophilopoulos, CRNA

• Adult Health Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.