Theresa A Davila, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085011269 Issued in IL

Practice address

1506 Spring St
Greenwood, SC 29646-4071

Phone

(864) 725-7900

Fax

(864) 725-7910

NPI assigned

Aug 28, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, SC, IL3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Self Medical GroupGroup PAC ID 6002953916, 393 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Ocala Hospital, Ocala, FL, CCN 100062
• Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tdavila72042@adventhealth.direct-ci.com
• Direct secure messaging: tdavila539958@selfregional.direct-ci.net

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.

• Self Medical Group

  • Surgery Physician
  • Greenwood, SC
  • NPI 1982836847
  Medicare reassignment Care Compare group
• Florida Hospital Medical Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234

  Physician Assistant

  Medicare reassignment NPD
• Northwestern Medical Faculty Foundation

  dba Northwestern Medical Group

  • Multi-Specialty Clinic/Center
  • Carol Stream, IL
  • NPI 1346235314
  Medicare reassignment NPD
• Nchmd Inc

  • Hematology & Oncology Physician
  • Naples, FL
  • NPI 1831120195
  Medicare reassignment
• Self Medical Group

  • Urgent Care Clinic/Center
  • Laurens, SC
  • NPI 1528495025
  NPD
• Self Medical Group

  • Diagnostic Radiology Physician
  • Greenwood, SC
  • NPI 1659839694
  NPD
• Florida Hospital Medical Group Inc

  dba Rothman Orthopaedics AdventHealth Medical Group at Minneola

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD
• Northwestern Medical Faculty Foundation

  dba Northwestern Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1417718479
  NPD
• Self Medical Group

  dba Advanced Gastroenterology

  • Gastroenterology Physician
  • Greenwood, SC
  • NPI 1841047560
  NPD (past)
• Clarksville Physician Services, LLC

  dba Dover Medical Clinic

  • Rural Health Clinic/Center
  • Dover, TN
  • NPI 1992077077
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Self Regional Healthcare

  dba Pain Management Greenwood

  • Pain Medicine (Anesthesiology) Physician
  • Greenwood, SC
  • NPI 1013867498

  Hospital

  Care Compare affiliation
• Self Regional Healthcare

  dba SRH - Inpatient Services

  • General Acute Care Hospital
  • Greenwood, SC
  • NPI 1023046612
  Care Compare affiliation
• Self Regional Healthcare

  dba SRH - Outpatient Services

  • General Acute Care Hospital
  • Greenwood, SC
  • NPI 1407887003
  Care Compare affiliation
• Self Regional Healthcare

  dba Pain Management Laurens

  • Pain Medicine (Anesthesiology) Physician
  • Clinton, SC
  • NPI 1720938103

  Hospital

  Care Compare affiliation
• Florida Hospital Ocala Inc

  dba Advent Health Ocala

  • General Acute Care Hospital
  • Ocala, FL
  • NPI 1740772268
  Care Compare affiliation

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

{
    "created_epoch": "1251417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1720211451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE STE 1520",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631290",
            "telephone_number": "708-923-4200",
            "fax_number": "708-923-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296464071",
            "telephone_number": "864-725-7900",
            "fax_number": "864-725-7910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3120 Waterman Way",
            "address_purpose": "LOCATION",
            "city": "Tavares",
            "state": "FL",
            "postal_code": "327785252",
            "country_code": "US",
            "telephone_number": "352-343-1216",
            "fax_number": "352-343-1582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12251 S 80th Ave Ste 1520",
            "address_purpose": "LOCATION",
            "city": "Palos Heights",
            "state": "IL",
            "postal_code": "604631290",
            "country_code": "US",
            "telephone_number": "708-923-4200",
            "fax_number": "708-923-4201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "THERESA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-28",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110282",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1544",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4837",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "1761",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085011269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason David Dahlberg, M.D.
• Courtney Channing Daniel, RPH
• William F. Darby Jr., M.D.
• Hilary S Darnell, NP
• Elizabeth Corley Davenport-Fox, DNP, APRN, ANP-BC
• Bryan Davis
• Carol Ann Davis, LISW CP
• Christy Lloyd Davis, M.S.P.
• Erin Elizabeth Davis
• Grace Davis

• Physician Assistant in Greenwood, SC
• Providers in Greenwood, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.