TRIDENT MEDICAL SERVICES D/B/A TRIDENT SENIOR HEALTH CENTER (NPI# 1740394071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740394071 |
| Entity Type | Organization |
| Organization Name | TRIDENT MEDICAL SERVICES D/B/A TRIDENT SENIOR HEALTH CENTER |
| Other Organization Name | TRIDENT SENIOR HEALTH CENTER |
| Practice Address |
9302 Medical Plaza Dr Suite C Charleston SC 29406-9142 |
| Practice Telephone | 8437970416 |
| Practice Fax Number | 8438474477 |
| Mailing Telephone | 8437970416 |
| Mailing Fax Number | 8438474477 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2008-03-24 |
| Authorized Official Name | MS. KIMBERLIE DENMARK (DIRECTOR) |
| Authorized Official Telephone | 8437970416 |
| Authorized Official Credential | RN |
| Is Organization Subpart | Y |
| Parent Organization Name | TRIDENT MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP1196 | 05 |
| Other Name | Type Code |
|---|---|
| Trident Senior Health Center | Doing Business As Name - Organization |
| Street Address |
9302 MEDICAL PLAZA DR SUITE C |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29406-9142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881143998 | April Daley | Nurse Practitioner | 9302 Medical Plaza Dr, B, Charleston, SC 29406-9142 | 2016-09-30 |
| 1356773089 | Alexis L. Schulte | Dietitian, Registered | 9302 Medical Plaza Dr, Charleston, SC 29406-9142 | 2013-08-05 |
| 1710113048 | David Michael Mccance, LLC | Internal Medicine | 9302 Medical Plaza Dr, Suite B, Charleston, SC 29406-9142 | 2009-06-01 |
| 1912125212 | David Michael Mccance, LLC | Internal Medicine | 9302 Medical Plaza Dr, Suite B, Charleston, SC 29406-9142 | 2007-04-23 |
| 1275639361 | David Michael Mccance | Internal Medicine | 9302 Medical Plaza Dr, Suite B, Charleston, SC 29406-9142 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023622289 | Sara Desmarais | Physical Therapist | 2760 Tricom St, North Charleston, SC 29406 | 2020-09-04 |
| 1669036448 | Pink Elephant Autism Project | In Home Supportive Care | 8738 Red Oak Drive, Charleston, SC 29406 | 2019-04-26 |
| 1083171185 | Medical University Hospital Authority | Pharmacy | 2250 Mall Drive, North Charleston, SC 29406 | 2019-02-25 |
| 1336627371 | Truesdale Medical Center LLC | Internal Medicine | 6296 Rivers Ave., Suite 310, N. Charleston, SC 29406 | 2018-08-01 |
| 1164914552 | Amanda R Dipiazza | Nurse Anesthetist, Certified Registered | 9330 Medical Plaza Dr Ste E, Charleston, SC 29406 | 2018-06-01 |
| 1982148490 | Trident Medical Center | Psychiatric Hospital | 9225 C Medical Plaza Drive, Charleston, SC 29406 | 2016-12-19 |
| 1649726217 | First Choice Counseling Services, LLC | Community/Behavioral Health | 2245 Greenridge Rd., Unit#414, North Charleston, SC 29406 | 2016-09-01 |
| 1821443896 | Liberty Doctors, LLC | Family Medicine | 9275 D Medical Plaza Dr., North Charleston, SC 29406 | 2016-04-27 |
| 1174984645 | Ashia George | Developmental Therapist | 6650 Rivers Avenue, Ste 100, Charleston, SC 29406 | 2016-03-11 |
| 1023488582 | Etta Smith | Counselor | 2470 Mall Dr Unit Cd, North Charleston, SC 29406 | 2015-09-28 |
| Find all providers in zip 29406 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447758032 | Crs Eyecare Services, Inc. | Clinic/Center | 112 Rutledge Ave Ste A, Charleston, SC 29401-1333 | 2018-01-29 |
| 1760829519 | Health First | Clinic/Center | 1115 Savannah Hwy, Charleston, SC 29407-7805 | 2013-06-03 |
| 1235108721 | Charleston Internal Medicine, LLC | Clinic/Center | 537 Folly Rd, Charleston, SC 29412-3007 | 2006-03-16 |
| 1174520068 | Jeffery L Deal | Clinic/Center | 1938 Charlie Hall Blvd Unit B, Charleston, SC 29414-6099 | 2005-07-07 |
| 1033778642 | Kanawha County Emergency Ambulance Authority Health and Wellness Board | Clinic/Center | 601 Brooks St, Charleston, WV 25301-1319 | 2019-06-07 |
| 1376033829 | Charleston Medical Associates | Clinic/Center | 1483 Tobias Gadson Blvd Ste 101, Charleston, SC 29407-4795 | 2018-05-10 |
| 1528560083 | Kanawha County Emergency Ambulance Authority | Clinic/Center | 601 Brooks St, Charleston, WV 25301-1319 | 2018-03-01 |
| 1639604929 | Lowcountry Wellness Center LLC | Clinic/Center | 1941 Savage Rd Ste 100e, Charleston, SC 29407-4788 | 2017-04-25 |
| 1770905952 | Charleston Primary Care Inc. | Clinic/Center | 506 W Lincoln Ave, Suite 200, Charleston, IL 61920-2453 | 2014-01-07 |
| 1336577238 | Western Arkansas Primary Care | Clinic/Center | 2617 E Main St, Charleston, AR 72933-9637 | 2013-10-31 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29406 |
Please comment or provide details below to improve the information on TRIDENT MEDICAL SERVICES D/B/A TRIDENT SENIOR HEALTH CENTER.
| 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.