Active NPI
Theresa Thomas, M.D.
- Pediatrics Physician
- Mount Pleasant, SC
National Provider Identifier
1629033980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 17520
- Practice address
- 1210 Chuck Dawley Blvd
Mount Pleasant, SC 29464-4186 - Phone
- (843) 971-1955
- Fax
- (843) 974-8044
- NPI assigned
- Apr 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 17520 | SC | Primary |
Addresses
Primary practice location
1210 Chuck Dawley Blvd
Mount Pleasant, SC 29464-4186
Mailing address
1210 Chuck Dawley Blvd
Mount Pleasant, SC 29464-4186
Phone (843) 971-1955
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 175205 | Medicaid | SC |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17520 | SC | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1629033980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 CHUCK DAWLEY BLVD",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294644186",
"telephone_number": "843-971-1955",
"fax_number": "843-974-8044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 CHUCK DAWLEY BLVD",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294644186",
"telephone_number": "843-971-1955",
"fax_number": "843-974-8044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "THERESA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-19",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "17520",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "175205",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.