Theobald Family Eye Care, LLP

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

THEOBALD FAMILY EYE CARE, LLP

Practice address

3308 W Arrowhead Rd
Duluth, MN 55811-4000

Phone

(218) 727-6400

Fax

(218) 727-3044

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Teresa TheobaldNPI 1902872518

Title

Owner/Partner

Phone

(218) 727-6400

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Theobald Family Eye Care Other name

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Teresa F Theobald, O.D.

  • Optometrist
  • Duluth, MN
  • NPI 1902872518
  NPD (past) Authorized official
• Staci Lynn Collison

  • Optometrist
  • Bemidji, MN
  • NPI 1588949648
  NPD (past)
• Whitney Page Lauer

  • Optometrist
  • Virginia, MN
  • NPI 1285164079
  NPD (past)
• Martin J Theobald, O.D.

  • Optometrist
  • Duluth, MN
  • NPI 1609842210
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720173909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3308 W ARROWHEAD RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114000",
            "telephone_number": "218-727-6400",
            "fax_number": "218-727-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3308 W ARROWHEAD RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114000",
            "telephone_number": "218-727-6400",
            "fax_number": "218-727-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEOBALD FAMILY EYE CARE, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THEOBALD",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "218-727-6400",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB6890",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS & FIRST PLAN",
            "identifier": "6C246TH",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Theobald Family Eye Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Optometrist in Duluth, MN
• Providers in Duluth, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.