TRIDENT MEDICAL CENTER, LLC (NPI# 1912029612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912029612 |
| Entity Type | Organization |
| Organization Name | TRIDENT MEDICAL CENTER, LLC |
| Other Organization Name | TRIDENT MEDICAL CENTER |
| Practice Address |
9330 Medical Plaza Dr Charleston SC 29406-9104 |
| Practice Telephone | 8437977000 |
| Practice Fax Number | 8437974086 |
| Mailing Telephone | 8437977000 |
| Mailing Fax Number | 8437974086 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2019-10-31 |
| Authorized Official Name | ANDY S. MILLER (CFO) |
| Authorized Official Telephone | 8438474100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | DPE045 | 05 |
| Other Name | Type Code |
|---|---|
| TRIDENT MEDICAL CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063813111 | Trident Medical Center, LLC | Clinic/Center | 5249 Emmett I. Davis Jr. Avenue, North Charleston, SC 29405 | 2014-09-09 |
| 1124443478 | Trident Medical Center, LLC | Psychiatric Unit | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2014-02-24 |
| 1598189797 | Trident Medical Center, LLC | Rehabilitation Unit | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2014-02-07 |
| 1659579084 | Trident Medical Center, LLC | General Acute Care Hospital | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2007-07-06 |
| 1386721405 | Trident Medical Center, LLC | General Acute Care Hospital | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2006-11-01 |
| 1932282258 | Trident Medical Center, LLC | Skilled Nursing Facility | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2006-10-23 |
| 1861447773 | Trident Medical Center, LLC | General Acute Care Hospital | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2006-05-23 |
| 1588619498 | Trident Medical Center, LLC | Skilled Nursing Facility | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2006-05-23 |
| Street Address |
9330 MEDICAL PLAZA DR |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29406-9104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285632638 | Thomas A Privett | Psychiatry & Neurology | 9330 Medical Plaza Dr, Charleston, SC 29406 | 2005-07-11 |
| 1740896380 | Robert Palmer Wolfrom | Nurse Anesthetist, Certified Registered | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2020-09-18 |
| 1801415872 | Holly Robinson | Nurse Anesthetist, Certified Registered | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2020-04-10 |
| 1578192951 | Destine Hoover | Pharmacist | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2020-04-07 |
| 1134751829 | Julie Ivester Hayler | Nurse Practitioner | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2020-02-10 |
| 1659903078 | Elizabeth Mary Chouinard | Registered Nurse | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2020-02-05 |
| 1174018162 | Priscilla Hurt | Social Worker | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2018-06-22 |
| 1669965810 | Jacquelyn Suzette Ammons | Nurse Practitioner | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2018-06-12 |
| 1396249819 | Jennifer L Allmon | Nurse Anesthetist, Certified Registered | 9330 Medical Plaza Dr, Charleston, SC 29406 | 2018-03-20 |
| 1609395458 | Mason Patrick Weisgarber | Physician Assistant | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2017-09-13 |
| Find all providers in the same location | ||||
| 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 | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568769354 | Wvupc-medicine & Specialty Office | Clinic/Center | 4522 Maccorkle Ave Se, Charleston, WV 25304-1840 | 2011-02-15 |
| 1912204702 | Wvupc-camc Fam Med Surgery Center | Clinic/Center | 1201 Washington St E, Charleston, WV 25301-1834 | 2011-02-15 |
| 1275840423 | Medical University of South Carolina | Clinic/Center | 25 Courtenay Dr, Charleston, SC 29425-8911 | 2010-09-09 |
| 1922323740 | G T Little Md P.a. | Clinic/Center | 280 Rutledge Ave, Charleston, SC 29403-5352 | 2010-04-05 |
| 1285860098 | Palmetto Vein Specialists, LLC | Clinic/Center | 9313 Medical Plaza Dr, Ste 303, Charleston, SC 29406-9155 | 2009-06-08 |
| 1295906816 | Coastal Gastroenterology & Hepatology LLC | Clinic/Center | 1616 Ashley River Rd, Charleston, SC 29407-5902 | 2008-03-24 |
| 1164690947 | Arrhythmia Specialists of Charleston | Clinic/Center | 125 Doughty St, Suite 695, Charleston, SC 29403-5736 | 2008-02-14 |
| 1033393954 | E Family Medicin Grp | Clinic/Center | 295 Calhoun St, Charleston, SC 29425-8904 | 2007-12-27 |
| 1174706337 | Seung-jun O, PC | Clinic/Center | 2097 Henry Tecklenburg Dr, Suite 212 West, Charleston, SC 29414-5740 | 2007-12-11 |
| 1962696112 | Jan H. Cunningham, Md, Pllc | Clinic/Center | 830 Pennsylvania Ave, 405, Charleston, WV 25302-3302 | 2007-08-30 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29406 |
Please comment or provide details below to improve the information on TRIDENT MEDICAL CENTER, LLC.
| 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.