Theresa Faith Economou, NURSE PRACTITIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

3125 Issued in SC

Practice address

1025 Verdae Blvd
Suite a
Greenville, SC 29607-4032

Phone

(864) 242-4683

Fax

(864) 240-5028

NPI assigned

Mar 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Network Geriatric Services, PA

  • Geriatric Medicine (Family Medicine) Physician
  • Spartanburg, SC
  • NPI 1922045103
  NPD (past)

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1780713461",
    "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",
            "telephone_number": "864-797-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 VERDAE BLVD",
            "address_2": "SUITE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296074032",
            "telephone_number": "864-242-4683",
            "fax_number": "864-240-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECONOMOU",
        "first_name": "THERESA",
        "middle_name": "FAITH",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "201404814NP-PP",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F301965",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "3125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADULT NURSE PRACTITIONER",
            "identifier": "201404814NP-PP",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "201403477 RN",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1489",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE RN",
            "identifier": "3125RX",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eckerd Corporation
• Kaitlin Ann Eckley, PA
• Madeline Noelle Eckman, OT
• William L Eckstein, MD
• Paul Borja Eclavea, M.D.
• Ecp South Carolina, P.a.
• C Jane Eddins, O.D.
• Todd Raymond Eddy, PHARM.D., BCPS, CACP
• William Jeffery Edenfield, MD
• McKenzie Edens

• All providers in Greenville, SC
• Adult Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.