Individual provider Active NPI

Theressa L Garris, PNP

  • Pediatric Nurse Practitioner
  • Florence, SC
National Provider Identifier
1013981612
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APN407 Issued in SC
Practice address
204 E Cheves St
Florence, SC 29506-2604
Phone
(843) 777-7601
Fax
(843) 662-2474
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APN407 SC Primary

Addresses

Primary practice location

204 E Cheves St
Florence, SC 29506-2604

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 777-7601

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address theressa.garris@mpaii.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN407SCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Physician Associates II Past Accepting new patients
McLeod Physician Associates II Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tgarris22074@directmcleodehealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1013981612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3239",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295023239",
            "telephone_number": "843-777-7601",
            "fax_number": "843-662-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E CHEVES ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062604",
            "telephone_number": "843-777-7601",
            "fax_number": "843-662-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRIS",
        "first_name": "THERESSA",
        "middle_name": "L",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "APN407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "theressa.garris@mpaii.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "ECW DA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "204 E Cheves St",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295062604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.