LISA DAWN THEOBALD PMHNP
NPI 1366136228
Nurse Practitioner - Psychiatric/Mental Health in Salem, OR
About Lisa Dawn Theobald Pmhnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LISA DAWN THEOBALD PMHNP (NPI 1366136228) is an individual psychiatric/mental health provider in Salem, Oregon, licensed in Oregon (10006245) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Lisa Dawn Theobald Pmhnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97302 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SALEM, OR 97302
SALEM, OR 97302
SALEM, OR 97302
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Lisa Theobald's NPI number?
The NPI number for Lisa Theobald is 1366136228. It was assigned to this individual provider in the NPPES registry on June 5, 2023.
Where is Lisa Theobald located?
Lisa Theobald practices at 2264 Mcgilchrist St SE Ste 100, Salem, OR 97302. The listed phone number is (503) 930-1812.
What is Lisa Theobald's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Lisa Theobald enrolled in Medicare?
Yes. Lisa Theobald is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
What insurance does Lisa Theobald accept?
Health plans from BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Lisa Theobald as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Lisa Theobald was last updated on March 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Lisa Dawn Theobald, PMHNP · NPI 1366136228
Psychiatric/Mental Health physician in Salem, Oregon. Individual provider, active in the CMS NPPES registry since June 5, 2023.
## Identity
- **NPI:** 1366136228 (Entity type: Individual)
- **Enumerated:** June 5, 2023
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 10006245 (Oregon)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2264 MCGILCHRIST ST SE STE 100, Salem, OR 97302-1008
- **Phone:** (503) 930-1812
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** March 13, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1366136228) · Data from the CMS NPPES public registry.