Individual provider Active NPI

Roger Theobald, AU.D.

  • Audiologist
  • Meridian, ID
National Provider Identifier
1417056201
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
1032 S Silverstone Way Ste 160
Meridian, ID 83642-1080
Phone
(208) 658-0238
NPI assigned
Sep 21, 2006
Last updated
Mar 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X Primary
Audiologist-Hearing Aid Fitter 237600000X
Hearing Instrument Specialist 237700000X

Addresses

Primary practice location

1032 S Silverstone Way Ste 160
Meridian, ID 83642-1080

Mailing address

1084 N Cole Rd
Boise, ID 83704-8642
Phone (208) 377-0019

Other practice location 1

1084 N Cole Rd
Boise, ID 83704-8642
Phone (208) 377-0019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190109002979 ID Practitioner - Qualified Audiologist 4587850813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
At Still University, Arizona School of Dentistry & Oral HLTH, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1032 S Silverstone Way
Suite 160
Meridian, ID 83642-1080
Phone (208) 658-0238

5513 N Glenwood St
Suite B
Boise, ID 83714-1332
Phone (208) 375-6600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Amplify Group LLC CurrentSince Dec 4, 2023 Accepting new patients
Audiology Unlimited & Hearing Aid Sales LLC Audiologist CurrentSince Mar 1, 2026 Accepting new patients
Matthew S. Murphy Audiologist-Hearing Aid Fitter PastSince Mar 11, 2022 Accepting new patients

Locations

1740 N Milwaukee St
#A
Boise, ID 83704
Phone (208) 658-0238

5513 N Glenwood St
Ste B
Garden City, ID 83714
Phone (208) 375-6600

1032 S Silverstone Way
Ste 160
Meridian, ID 83642
Phone (208) 658-0238

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1417056201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1084 N COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048642",
            "telephone_number": "208-377-0019",
            "fax_number": "208-377-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 S SILVERSTONE WAY STE 160",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421080",
            "telephone_number": "208-658-0238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1084 N Cole Rd",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837048642",
            "country_code": "US",
            "telephone_number": "208-377-0019",
            "fax_number": "208-377-0313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THEOBALD",
        "first_name": "ROGER",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.