TRIDENT PAIN CENTER P A (NPI# 1154757482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154757482 |
| Entity Type | Organization |
| Organization Name | TRIDENT PAIN CENTER P A |
| Practice Address |
108 N Highway 52 Moncks Corner SC 29461-3910 |
| Mailing Address |
9267 Medical Plaza Dr Ste G N Charleston SC 29406-9139 |
| Practice Telephone | 8437973636 |
| Practice Fax Number | 8437973637 |
| Mailing Telephone | 8437973636 |
| Mailing Fax Number | 8437973637 |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2019-10-03 |
| Authorized Official Name | DR. JOSEPH EDWARD NOLAN (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8437973636 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | TRIDENT PAIN CENTER P A |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP3479 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659915445 | Trident Pain Center P A | Pain Medicine | 176 Mcswain Dr, West Columbia, SC 29169-4825 | 2019-11-05 |
| 1437793353 | Trident Pain Center P A | Pain Medicine | 205 Eddie Chasteen Dr, Walterboro, SC 29488-5728 | 2019-11-04 |
| 1124661194 | Trident Pain Center P A | Anesthesiology | 1930 Charlie Hall Blvd, Charleston, SC 29414-5837 | 2019-10-23 |
| 1104468594 | Trident Pain Center P A | Anesthesiology | 4711 Sunset Blvd, Lexington, SC 29072-9151 | 2019-10-17 |
| Street Address |
108 N HIGHWAY 52 |
| City | MONCKS CORNER |
| State | SC |
| Zip Code | 29461-3910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982267605 | Berkeley Citizens Inc | Early Intervention Provider Agency | P0 Drawer 429 1301 Old Hwy 52 South, Moncks Corner, SC 29461 | 2019-04-18 |
| 1376015222 | Anthony Johnson | Counselor | 306 Airport Drive, Moncks Corner, SC 29461 | 2018-12-17 |
| 1598243719 | Jana Matthews Chinners | Family Medicine | 2061 Us-52, Moncks Corner, SC 29461 | 2018-07-31 |
| 1285151225 | Nathan Andrew Bostrom | Occupational Therapist | 118 Carolina Avenue, Moncks Corner, SC 29461 | 2017-08-29 |
| 1942730528 | Martina Snider | Specialist | 393 Corner Square Plaza, Moncks Corner, SC 29461 | 2017-06-15 |
| 1104355502 | Mary Elizabeth Perdue | Counselor | 306 Airport Dr., Moncks Corner, SC 29461 | 2017-06-08 |
| 1619390481 | Berkeley Citizens, Inc. | Public Health or Welfare | 1301 Old Hwy. 52 South, Moncks Corner, SC 29461 | 2014-01-29 |
| 1326384082 | Amanda Trueworthy | Counselor | 3156 F South Live Oak Drive, Moncks Corner, SC 29461 | 2012-12-27 |
| 1790040202 | Melanie Mcendree | Community Health Worker | 105 Lobolly Dr., Moncks Corner, SC 29461 | 2012-07-10 |
| 1891093845 | Leslie Erin Blackmon Stelling | Pharmacist | 110 South Highway 52, Moncks Corner, SC 29461 | 2011-02-28 |
| Find all providers in zip 29461 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982246633 | Southern Coast Specialists, LLC | Anesthesiology | 16 Okatie Center Blvd S Ste 201, Bluffton, SC 29909-7544 | 2019-10-15 |
| 1487120622 | Pain Specialists of Charleston | Anesthesiology | 135 Sea Island Pkwy, Beaufort, SC 29907-1500 | 2018-10-15 |
| 1235610767 | Premier Pain Solutions Pllc | Anesthesiology | 201 Richard St Ste A, Easley, SC 29640-1442 | 2018-08-23 |
| 1902316557 | Anesthesia Aficianados, LLC | Anesthesiology | 10630 Clemson Blvd Ste 200, Seneca, SC 29678-4545 | 2017-10-10 |
| 1285157735 | Sgkf LLC | Anesthesiology | 764 Saint Andrews Blvd, Charleston, SC 29407-7168 | 2017-07-17 |
| 1053860841 | Emergencymd, LLC | Anesthesiology | 2555 Boiling Springs Rd, Boiling Springs, SC 29316-5351 | 2016-09-22 |
| 1992156400 | Arcis Healthcare, LLC | Anesthesiology | 109 Park Place Ct, Lexington, SC 29072-6690 | 2016-06-27 |
| 1215302823 | Low Country Pain & Spine | Anesthesiology | 9180 Ocean Hwy Unit 6, Pawleys Island, SC 29585-8670 | 2015-12-08 |
| 1760888127 | Seaside Professional Services LLC | Anesthesiology | 25 Sherington Park Drive, Suite D-1, Bluffton, SC 29910 | 2014-11-13 |
| 1336559830 | Ryan Peyton Hostutler | Anesthesiology | 201 Richard St Unit A, Easley, SC 29640-1442 | 2014-05-06 |
| Find all providers with the same taxonomy | ||||
| City | MONCKS CORNER |
| Zip Code | 29461 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.