Shelly D Theobald (NPI# 1386078418, PAC ID# 5597984583) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1386078418 |
| PAC ID by PECOS | 5597984583 |
| Professional Enrollment ID | I20190328000861 |
| Full Name | Shelly D Theobald |
| Organization Legal Name | THE ST THOMAS EAST END MEDICAL CENTER CORPORATION |
| Address |
4605 Tutu Park Mall St Thomas VI 00802-1736 |
| Phone Number | 3407753700 |
| Gender | F |
| Graduation Year | 2013 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 1153366398 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 480001 | ROY LESTER SCHNEIDER HOSPITAL,THE |
| Address | Phone | Organization |
|---|---|---|
| 4605 Tutu Park Mall, St Thomas, VI 00802-1736 | 3407753700 | THE ST THOMAS EAST END MEDICAL CENTER CORPORATION |
| 4605 Tutu Park Mall, Suite 207, St Thomas, VI 00802-1736 | 3407753700 | THE ST THOMAS EAST END MEDICAL CENTER CORPORATION |
| Organization Legal Name | THE ST THOMAS EAST END MEDICAL CENTER CORPORATION |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Audria B Thomas | Allergy/immunology | The St Thomas East End Medical Center Corporation | 4605 Tutu Park Mall, Suite 207, St Thomas, VI 00802-1736 |
| Debra L Wright Francis | Obstetrics/gynecology | The St Thomas East End Medical Center Corporation | 4605 Tutu Park Mall, Suite 207, St Thomas, VI 00802-1736 |
| Barbara G Douglas | Internal Medicine | The St Thomas East End Medical Center Corporation | 4605 Tutu Park Mall, Suite 207, St Thomas, VI 00802-1736 |
| Madel B Villegas | Family Medicine | The St Thomas East End Medical Center Corporation | 4605 Tutu Park Mall, Suite 207, St Thomas, VI 00802-1736 |
| Dionne M Simmonds | Clinical Social Worker | The St Thomas East End Medical Center Corporation | 4605 Tutu Park Mall, Suite 207, St Thomas, VI 00802-1736 |
| Jarle Z Meservy | Psychiatry | The St Thomas East End Medical Center Corporation | 4605 Tutu Park Mall, Suite 207, St Thomas, VI 00802-1736 |
| Lori A Thompson | Psychologist, Clinical | The St Thomas East End Medical Center Corporation | 4605 Tutu Park Mall, Suite 207, St Thomas, VI 00802-1736 |
| Street Address |
4605 TUTU PARK MALL |
| City | ST THOMAS |
| State | VI |
| Zip | 00802-1736 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Audria B Thomas | Allergy/immunology | The St Thomas East End Medical Center Corporation | 4605 Tutu Park Mall, Suite 207, St Thomas, VI 00802-1736 |
| Debra L Wright Francis | Obstetrics/gynecology | The St Thomas East End Medical Center Corporation | 4605 Tutu Park Mall, Suite 207, St Thomas, VI 00802-1736 |
| Barbara G Douglas | Internal Medicine | The St Thomas East End Medical Center Corporation | 4605 Tutu Park Mall, Suite 207, St Thomas, VI 00802-1736 |
| Madel B Villegas | Family Medicine | The St Thomas East End Medical Center Corporation | 4605 Tutu Park Mall, Suite 207, St Thomas, VI 00802-1736 |
| Dionne M Simmonds | Clinical Social Worker | The St Thomas East End Medical Center Corporation | 4605 Tutu Park Mall, Suite 207, St Thomas, VI 00802-1736 |
| Jarle Z Meservy | Psychiatry | The St Thomas East End Medical Center Corporation | 4605 Tutu Park Mall, Suite 207, St Thomas, VI 00802-1736 |
| Lori A Thompson | Psychologist, Clinical | The St Thomas East End Medical Center Corporation | 4605 Tutu Park Mall, Suite 207, St Thomas, VI 00802-1736 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jovanni Jenkins | Physical Therapy | Vi Neurological Medical Group Inc. | 9003 Havensight Mall Havensight, St Thomas, VI 00802 |
| Kevin L Lenahan | Chiropractic | 9003 Havensight Mall, Suite 304, St Thomas, VI 00802 | |
| Michael D Kyzer | Internal Medicine | Ambulatory Care Clinic L.l.c | 9053 Estate Thomas, Suite 106, St Thomas, VI 00802 |
| Patrick D Buchar | Chiropractic | Rt 38 Raphune Hill Bays, 407 8, St Thomas, VI 00802 | |
| Nicholas Thomas Rex | Physical Therapy | Therapy Works, LLC | 8 Barbel Plz Ab, St Thomas, VI 00802 |
| Byron W Biscoe Jr. | Ophthalmology | 8000 Nisky Ctr, 19b, St Thomas, VI 00802 | |
| Seshagari Alla | General Practice | 1606 6th St Sugar Estate, St Thomas, VI 00802 | |
| Eric T Fergen | Physician Assistant | Ambulatory Care Clinic L.l.c | 9053 Estate Thomas, Suite 106, St Thomas, VI 00802 |
| James D Nelson | Neurology | Vi Neurological Medical Group Inc. | 9003 Havensight Mall Havensight, St Thomas, VI 00802 |
| Elizabeth A Brown | Physical Therapy | Cog Restore, LLC | 9053 Estate Thomas, Royal Palms Suite 206, St Thomas, VI 00802 |
| Find all physicians in zip 00802 | |||
| City | ST THOMAS |
| Zip Code | 00802 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | ST THOMAS + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Shelly D Theobald.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.