Individual provider Active NPI

Theresa Mary Sexton, APRN

  • Pediatric Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1316049497
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
19435 Issued in SC
Practice address
142 Milestone Way
Greenville, SC 29615-5065
Phone
(864) 558-0092
Fax
(855) 269-6611
NPI assigned
Sep 1, 2006
Last updated
Jul 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN19435 SC
Pediatric Nurse Practitioner 363LP0200X ARNP1755352 FL
Pediatric Nurse Practitioner 363LP0200X 19435 SC Primary

Addresses

Primary practice location

142 Milestone Way
Greenville, SC 29615-5065

Mailing address

142 Milestone Way
Greenville, SC 29615-5065
Phone (864) 558-0092

Other names 1

  • Terry Mary Sexton Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180117000240 SC Practitioner - Nurse Practitioner 4688765258 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN19435SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children CurrentSince Oct 28, 2017 Accepting new patients
Shriners Hospitals for Children CurrentSince Oct 28, 2017 Accepting new patients
Shriners Hospitals for Children Past Accepting new patients
Achieve MD Past Accepting new patients

Locations

950 W Faris Rd
Greenville, SC 29605
Phone (864) 255-7941

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1316049497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 MILESTONE WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296155065",
            "telephone_number": "864-558-0092",
            "fax_number": "855-269-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 MILESTONE WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296155065",
            "telephone_number": "864-558-0092",
            "fax_number": "855-269-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEXTON",
        "first_name": "THERESA",
        "middle_name": "MARY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "APN19435",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP1755352",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "19435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRY",
            "last_name": "SEXTON",
            "middle_name": "MARY",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.