Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Theresa A Davila, PA-C

Individual provider Physician Assistant · NPI 1720211451

Theresa A Davila, PA-C is a Physician Assistant in Greenwood, South Carolina. Qualified in 2009, 17 years ago. Practices with Self Medical Group, a 396-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Florida, Illinois, New Hampshire and South Carolina and 1 more.

Years since qualifying
17
Licensed in
FL, IL, NH, SC, TN
In the registry since
2009
Specialties on file
5
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1506 Spring St
Greenwood, SC 29646-4071
Phone: (864) 725-7900
Fax: (864) 725-7910
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 3120 Waterman Way, Tavares, FL 32778-5252 — (352) 343-1216
  • 12251 S 80th Ave Ste 1520, Palos Heights, IL 60463-1290 — (708) 923-4200

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085011269 (IL)
Physician Assistant Taxonomy 363A00000X · Licence PA9110282 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 1544 (NH)
Physician Assistant Taxonomy 363A00000X · Licence 4837 (SC)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 1761 (TN)

Record details

NPI number1720211451
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 28, 2009
Last updated in NPPESJune 24, 2025
Certification dateJune 24, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Self Medical Group — 396 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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