MARTIN J THEOBALD (NPI# 1609842210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609842210 |
| Entity Type | Individual |
| Full Name | MARTIN J THEOBALD |
| Credential | O.D. |
| Practice Address |
3308 W Arrowhead Rd Duluth MN 55811-4000 |
| Practice Telephone | 2187276400 |
| Mailing Telephone | 2187276400 |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2549 | MN | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MEDICA | 2207594 | 01 |
| MN | ATRIUM & BCBS | 6C248TH | 01 |
| MN | FIRST PLAN MINNESOTA | 6C248TH | 01 |
| MN | PREFERRED ONE | 897821023475 | 01 |
| MN | PREFERRED ONE | A62871023475 | 01 |
| MN | UCARE | 110960 | 01 |
| MN | MEDICA | 2203074 | 01 |
| Street Address |
3308 W ARROWHEAD RD |
| City | DULUTH |
| State | MN |
| Zip Code | 55811-4000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902872518 | Teresa F Theobald | Optometrist | 3308 W Arrowhead Rd, Duluth, MN 55811-4000 | 2006-02-23 |
| 1710166541 | Mark D. Homstad, D.p.m., P.a. | Podiatrist | 3308 W Arrowhead Rd, Duluth, MN 55811-4000 | 2007-10-29 |
| 1720173909 | Theobald Family Eye Care, LLP | Optometrist | 3308 W Arrowhead Rd, Duluth, MN 55811-4000 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417515339 | Kyle Olson-merrick | Dentist | 320 W Myrtle St, Ste 100, Duluth, MN 55811 | 2019-06-05 |
| 1184288979 | Pdg, P.a. | Clinic/Center | 4891 Miller Truck Hwy., Suite 100, Hermantown, MN 55811 | 2019-04-26 |
| 1528589843 | Breanna Joy Greenly | Counselor | 4720 Burning Tree Road, Birch Tree Center, Duluth, MN 55811 | 2017-06-28 |
| 1396102398 | Debbie Christian | Registered Nurse | 4815 Burning Tree Rd Suite 100, Duluth, MN 55811 | 2016-01-21 |
| 1831556935 | Megan Marie Paris | Psychologist | 715 East Central Entrance, Duluth, MN 55811 | 2016-01-20 |
| 1740666908 | Angela Fedo | Physical Therapy Assistant | 2101 Trinity Rd, Duluth, MN 55811 | 2015-08-10 |
| 1649657479 | Kayla Stephenson | Specialist/Technologist | 5024 Morris Thomas Road, Hermantown, MN 55811 | 2015-04-30 |
| 1073918843 | Northern Lives Inc. | Assisted Living Facility | 4014 Trinity Road, Duluth, MN 55811 | 2014-10-23 |
| 1114326238 | Donald Hermanson | Specialist/Technologist | 801 Boulder Drive, Apt. 202, Duluth, MN 55811 | 2014-08-14 |
| 1679990857 | Jodie Little | Pharmacist | 801 W. Central Entrance, Shopko Pharmacy 2114, Duluth, MN 55811 | 2014-03-25 |
| Find all providers in zip 55811 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831703289 | First Class Eye Care, LLC | Optometrist | 2730 Peachtree Industrial Blvd Ste 206, Duluth, GA 30097-8628 | 2020-09-03 |
| 1073172334 | National Vision Inc | Optometrist | 5115 Burning Tree Rd Ste 311, Duluth, MN 55811-1876 | 2019-06-11 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1396263026 | Lindsay Jordan Armagon | Optometrist | 2435 Commerce Ave Bldg 2200, Duluth, GA 30096-4980 | 2017-09-01 |
| 1669909701 | Vuon Lay Nim | Optometrist | 3940 Buford Hwy Ste A104, Duluth, GA 30096-8212 | 2017-05-19 |
| 1922457183 | Zen Eye Care Pllc | Optometrist | 2106 London Road, Duluth, MN 55812 | 2016-06-08 |
| 1215312459 | Vision Pro II, Inc | Optometrist | 4920 Grand Ave, Duluth, MN 55807-2604 | 2015-07-29 |
| 1265873509 | Keping Xu | Optometrist | 2205 Pleasant Hill Rd Ste 125, Duluth, GA 30096-2308 | 2013-07-15 |
| 1275819849 | Marina L. Gurvich | Optometrist | 6555 Sugarloaf Pkwy Ste 305, Duluth, GA 30097-4929 | 2011-10-27 |
| 1619274941 | Bethel Eyecare | Optometrist | 2148 Duluth Hwy Ste 102, Duluth, GA 30097-4504 | 2011-02-23 |
| Find all providers in DULUTH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.