BENJAMIN DAVID THEOBALD (NPI# 1053846287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053846287 |
| Entity Type | Individual |
| Full Name | BENJAMIN DAVID THEOBALD |
| Credential | MD |
| Practice Address |
101 E Wood St Spartanburg SC 29303-3040 |
| Mailing Address |
Po Box 743070 Atlanta GA 30374-3070 |
| Practice Telephone | 8645607025 |
| Practice Fax Number | 8645607388 |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2020-06-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 41006 | SC | Allopathic & Osteopathic Physicians |
| Street Address |
101 E WOOD ST |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29303-3040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407858467 | Steven William Corso | Internal Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2005-06-02 |
| 1932713203 | Warren Everett Evans | Surgery | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-09-03 |
| 1023628096 | Zoe Kyle | Nurse Practitioner | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-08-05 |
| 1952928897 | Marcus Kyle Mauney | Registered Nurse | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-26 |
| 1679198618 | Raymond Briggs Westby | Surgery | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-16 |
| 1477178754 | Brewer Mccann Carter | Surgery | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-11 |
| 1982229704 | Kathryn Dewalt Rubel | Nurse Anesthetist, Certified Registered | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-09 |
| 1255956074 | Benjamin Todd Reeves | Internal Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-09 |
| 1952926685 | Mason Runge | Internal Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-09 |
| 1013531045 | Ryan Scott Rhodes | Internal Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013532126 | Adam Joseph Fulcher | Family Medicine | Center for Family Medicine, 853 N. Church Street, Suite 510, Spartanburg, SC 29303 | 2020-06-15 |
| 1275011652 | Tri-state Medical Supplies, North Grove | Durable Medical Equipment & Medical Supplies | 1330 Boiling Springs Rd Ste 2900, Spartanburg, SC 29303 | 2018-07-30 |
| 1992227151 | Roxanne Pope | Speech-Language Pathologist | 290 N Grove Medical Park Dr., Spartanburg, SC 29303 | 2017-07-10 |
| 1861934879 | Cortney Redmond Mckinney I | Counselor | 250 Dewey Sve., Spartanburg, SC 29303 | 2016-11-08 |
| 1578011474 | Instride Foot and Ankle Specialists, Pllc | Podiatrist | 269 North Grove Medical Drive, Spartanburg, SC 29303 | 2016-09-20 |
| 1023477536 | Whitney Brooke Terry | Physician Assistant | 391 Serpentine Dr Ste 250, Spartanburg, SC 29303 | 2016-02-12 |
| 1306244348 | Medcare Urgent Care Spartanburg, LLC | Clinic/Center | 301 E Wood Street, Spartanburg, SC 29303 | 2014-12-08 |
| 1508201393 | Tom Ju | Anesthesiology | 1330 Boiling Springs Rd Ste 2700, Spartanburg, SC 29303 | 2013-05-07 |
| 1295072312 | Marie O'dell | Registered Nurse | 7 698 Howard Street, Spartanburg School District, Spartanburg, SC 29303 | 2013-01-09 |
| 1518203330 | Sherard Hamilton Ansley | Speech-Language Pathologist | 698 Howard St., Spartanburg School District 7, Spartanburg, SC 29303 | 2012-12-26 |
| Find all providers in zip 29303 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033581384 | Doctors Care Sc, Pa | Emergency Medicine | 300 E Blackstock Rd, Suite E, Spartanburg, SC 29301-3787 | 2015-10-27 |
| 1205889409 | Bernard Augustus Corbett IIi | Emergency Medicine | 151 Peachwood Centre Dr, Spartanburg, SC 29301-2575 | 2006-05-18 |
| 1740250174 | Chloe P Brewington | Emergency Medicine | 101 East Wood St, Emergency Center, Spartanburg, SC 29303-3040 | 2006-01-26 |
| 1831160191 | Theresa Domers | Emergency Medicine | 172 W Woodglen Rd, Spartanburg, SC 29301-5305 | 2006-01-26 |
| 1073046157 | Kristin Demosthenes Rowland | Emergency Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2017-04-06 |
| 1902250707 | Paulina Narendra Patel | Emergency Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2016-04-18 |
| 1568816536 | Warren Doyle | Emergency Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2016-04-15 |
| 1750720686 | Joseph G Sorber | Emergency Medicine | 101 E Wood St, Spartanburg, SC 29303 | 2013-06-25 |
| 1053654772 | Rosanna Patrice Couture | Emergency Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2013-04-01 |
| 1265775217 | Katherine Jane Langley | Emergency Medicine | 101 E Wood St, Spartanburg, SC 29303 | 2013-03-28 |
| Find all providers in SPARTANBURG | ||||
| City | SPARTANBURG |
| Zip Code | 29303 |
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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.