THEOBALD MEDICAL CENTER LLC
NPI 1700731957
Nurse Practitioner - Primary Care in Kemp, TX

NPI Status: Active since March 03, 2026

Contact Information

13058 E HIGHWAY 175 STE 4
KEMP, TX
ZIP 75143
Phone: (940) 230-3173

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  • Organization
  • Nurse Practitioner
  • Primary Care
  • CLIA Number: 45D2340063
  • CLIA Cert. Type: Practitioner Other
  • CLIA Exp. Date: 03-10-2028

About THEOBALD MEDICAL CENTER LLC

This page provides the complete NPI Profile along with additional information for Theobald Medical Center Llc, a provider established in Kemp, Texas operating as a Nurse Practitioner, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1700731957 assigned on March 2026. The practitioner's primary taxonomy code is 363LP2300X. The provider is registered as an organization and their NPI record was last updated March 2026. Theobald Medical Center Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Angela Theobald (Owner)

NPI
1700731957
Provider Name
THEOBALD MEDICAL CENTER LLC
Entity Type
Organization
Location Address
13058 E HIGHWAY 175 STE 4 KEMP, TX 75143
Location Phone
(940) 230-3173
Mailing Address
13058 E HIGHWAY 175 STE 4 KEMP, TX 75143
Mailing Phone
(940) 230-3173
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-03-2026
Last Update Date
03-03-2026
Code Navigator

A nurse practitioner (NP) like Theobald Medical Center Llc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner Primary Care

Taxonomy Code
363LP2300X
Type
Physician Assistants & Advanced Practice Nursing Providers

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ANGELA THEOBALD

Authorized Official Title
OWNER
Authorized Official Phone
(940) 230-3173

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
45D2340063
Facility Type
Practitioner Other
Certificate Effective Date
March 11, 2026
Certificate Expiration Date
March 10, 2028
Laboratory Director
ANGELA THEOBALD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Theobald Medical Center Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1700731957, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
0
Doubled → 0
Pos 4
0
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
3
Unchanged
Pos 7
1
Doubled → 2
Pos 8
9
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 7 → 14 → 5 1 → 2 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 0 + 0 + 1 + 4 + 3 + 2 + 9 + 1 + 0 + 24 = 53

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1700731957.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1700731957, enumerated as an "organization" on March 03, 2026.

The provider is located at 13058 E HIGHWAY 175 STE 4 KEMP, TX 75143 and the phone number is (940) 230-3173.

Nurse Practitioner with taxonomy code 363LP2300X and a focus in Primary Care.