TRIDENT ANESTHESIA GROUP, LLC (NPI# 1952597551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952597551 |
| Entity Type | Organization |
| Organization Name | TRIDENT ANESTHESIA GROUP, LLC |
| Other Organization Name | PAIN CARE PHYSICIANS OF CHARLESTON, LLC |
| Practice Address |
9263 Medical Plaza Dr Ste B Charleston SC 29406-7112 |
| Mailing Address |
9263 Medical Plaza Dr Suite E Charleston SC 29406-7112 |
| Practice Telephone | 8434141224 |
| Practice Fax Number | 8434141226 |
| Mailing Telephone | 8434141224 |
| Mailing Fax Number | 8434141226 |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2012-07-19 |
| Authorized Official Name | DR. RICHARD L FISHMAN (PARTNER/MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8434141224 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| 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 | GP4750 | 05 | |
| SC | GP0090 | 05 |
| Other Name | Type Code |
|---|---|
| Pain Care Physicians of Charleston, LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376595520 | Trident Anesthesia Group, LLC | Anesthesiology | 9263 Medical Plaza Dr., Ste E, Charleston, SC 29406-7112 | 2006-05-16 |
| Street Address |
9263 MEDICAL PLAZA DR STE B |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29406-7112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689670945 | Sheryl Walker | Anesthesiology | 9263 Medical Plaza Dr, Ste E, Charleston, SC 29406-7112 | 2005-06-22 |
| 1710439286 | Rachel N Brown | Nurse Anesthetist, Certified Registered | 9263 Medical Plaza Dr, Ste E, Charleston, SC 29406-7109 | 2016-10-31 |
| 1790236800 | Laura Gilbert | Nurse Anesthetist, Certified Registered | 9263 Medical Plaza Dr, Ste E, Charleston, SC 29406-7112 | 2016-10-24 |
| 1669870929 | Lucas Willoughby | Nurse Anesthetist, Certified Registered | 9263 Medical Plaza Dr, Ste E, Charleston, SC 29406-7112 | 2014-12-18 |
| 1659779916 | Brooke Barnhardt | Nurse Anesthetist, Certified Registered | 9263 Medical Plaza Dr, Ste E, Charleston, SC 29406-7112 | 2014-12-18 |
| 1891191763 | Aaron Waters | Nurse Anesthetist, Certified Registered | 9263 Medical Plaza Dr, Ste E, Charleston, SC 29406-7109 | 2014-11-05 |
| 1952707812 | Emily Wade Beasley | Nurse Anesthetist, Certified Registered | 9263 Medical Plaza Dr, Ste E, Charleston, SC 29406-7109 | 2014-11-05 |
| 1871847814 | Roger A Southall, Jr | Nurse Anesthetist, Certified Registered | 9263 Medical Plaza Dr, Ste E, Charleston, SC 29406-7112 | 2012-10-30 |
| 1104181353 | Bethany D Stephenson | Massage Therapist | 9263 Medical Plaza Dr, Ste D, Charleston, SC 29406-7109 | 2012-07-12 |
| 1396000691 | Lisa H Beauford | Massage Therapist | 9263 Medical Plaza Dr, Ste D, Charleston, SC 29406-7109 | 2012-07-12 |
| 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 | 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 |
|---|---|---|---|---|
| 1285157735 | Sgkf LLC | Anesthesiology | 764 Saint Andrews Blvd, Charleston, SC 29407-7168 | 2017-07-17 |
| 1144248907 | Mid-atlantic Anesthesia Consultants, LLC | Anesthesiology | 100 Peyton Way Ste 200, Charleston, WV 25309-8545 | 2006-07-18 |
| 1396776670 | Anesthesia Associates of Charleston, P.a. | Anesthesiology | 125 Doughty St Ste 420, Charleston, SC 29403-5741 | 2006-07-05 |
| 1336756907 | Denovo Pain Management, LLC | Anesthesiology | 1012 Physicians Dr Ste 102, Charleston, SC 29414-5719 | 2020-09-28 |
| 1124661194 | Trident Pain Center P A | Anesthesiology | 1930 Charlie Hall Blvd, Charleston, SC 29414-5837 | 2019-10-23 |
| 1982065025 | Mid-atlantic Anesthesia Consultants, LLC | Anesthesiology | 100 Peyton Way Ste 200, Charleston, WV 25309-8545 | 2016-03-17 |
| 1962897272 | Alyson Marie Engle | Anesthesiology | 400 Court St Ste 100, Charleston, WV 25301-1652 | 2015-04-02 |
| 1215251921 | Charleston Pain Care, LLC | Anesthesiology | 9263 Medical Plaza Dr, Ste B, Charleston, SC 29406-7112 | 2010-03-24 |
| 1881788636 | Russell Jeffrey Seymore | Anesthesiology | 171 Ashley Ave, Charleston, SC 29425-8908 | 2006-10-03 |
| 1831116375 | Center for Pain Relief, Inc. | Anesthesiology | 400 Court St Ste 100, Charleston, WV 25301-1652 | 2006-07-17 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29406 |
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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.