Theodore Matthew Eison, MD

Primary specialty

Pediatric Nephrology PhysicianTaxonomy code 2080P0210X

License

35122 Issued in SC

Practice address

200 Patewood Dr Ste A115
Greenville, SC 29615-3547

Phone

(864) 454-5105

Fax

(864) 454-5689

NPI assigned

Jan 9, 2007

Last updated

Mar 22, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

Medical University of South Carolina College of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: teison7287@direct.ghs.myhfn.org

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

• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  Medicare reassignment Care Compare group NPD
• Greenville Health System

  dba GHS Patewood Memorial Hospital

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1568532513
  Medicare reassignment NPD
• Greenville Health System

  dba GHS Patewood Op Center BLDG a

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1225453269
  NPD
• Prisma Health University Medical Group

  dba Parkside OB-GYN

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD
• Prisma Health University Medical Group

  dba UMG Easley

  • Family Medicine Physician
  • Easley, SC
  • NPI 1295218642
  NPD
• Ut Lebonheur Pediatric Specialists, Inc.

  • Pediatrics Physician
  • Memphis, TN
  • NPI 1093024101

  Pediatric Nephrology

  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1184773582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE A115",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153547",
            "telephone_number": "864-454-5105",
            "fax_number": "864-454-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISON",
        "first_name": "THEODORE",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "TN",
            "license": "42534",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "SC",
            "license": "35122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Anna Lusk Eikost, PT, DPT, MS
• Ashley Eiseman, PHARMD
• Danielle Makupson Eison, PA-C
• James Donald Eison
• Laura A. Eison, P.T.
• Stacey Anne Ejiri, R.N.
• Ngozi Ogechi Eke, FNP
• Dima El Zein, M.D.
• Ezzat El-Bayoumi, MD
• Assil Jihad El-Ghali

• Pediatric Nephrology Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Pediatric Nephrology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.