Jeremy Boyd Theobald, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

0014231 Issued in OR

Practice address

1010 7TH Ave SW
Albany, OR 97321-1922

Phone

(541) 812-5071

Fax

(541) 812-5077

NPI assigned

Oct 28, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Albany General Hospital

  dba Samaritan InterCommunity Health Clinic - Albany

  • Family Medicine Physician
  • Albany, OR
  • NPI 1306679816
  NPD (past)
• Albany General Hospital

  dba Elm Street Pharmacy

  • Community/Retail Pharmacy
  • Albany, OR
  • NPI 1548313356
  NPD (past)

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1982076022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 7TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211922",
            "telephone_number": "541-812-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 7TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211922",
            "telephone_number": "541-812-5071",
            "fax_number": "541-812-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOBALD",
        "first_name": "JEREMY",
        "middle_name": "BOYD",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-28",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "0014231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Corvallis Clinic P C (Corvallis Clinic Waverly Drive)
• The Corvallis Clinic P C (Corvallis Clinic North Albany DME only)
• The Eye Team, PC
• The Eye Team, PC (The Eye Team Albany)
• Deborah Ann Thelen, QMHA
• Therapeutic Associates Inc
• Christine Elizabeth Thom, REGISTERED NURSE
• Geoffrey Thoma, LPC
• Justin Drew Thomas
• Sierra N Thomas, PERSONAL CARE ATTEND

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Albany, OR
• Providers in Albany, OR by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.