Individual provider Active NPI

Michael Chad Atchley Sr., P.A.

  • Physician Assistant
  • West Columbia, SC
National Provider Identifier
1104092204
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
176 McSwain Dr
West Columbia, SC 29169-4825
Phone
(843) 797-3636
Fax
(843) 797-3637
NPI assigned
May 8, 2008
Last updated
Jul 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

176 McSwain Dr
West Columbia, SC 29169-4825

Mailing address

9267 Medical Plaza Dr
N Charleston, SC 29406-9139
Phone (843) 797-3636

Other practice location 1

120 Highland Center Dr
Columbia, SC 29203-9127
Phone (843) 797-3636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200217001115 SC Practitioner - Physician Assistant 8022445832 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trident Pain Center LLCGroup PAC ID 7911897269, 18 clinicians

Practice addresses (Care Compare)

176 McSwain Dr
West Columbia, SC 29169-4825
Phone (843) 797-3636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Pain Associates PLLC CurrentSince Jan 1, 2026 Accepting new patients
Commonwealth Pain Associates, PLLC Physician Assistant CurrentSince Jan 1, 2026 Accepting new patients
Trident Pain Center LLC CurrentSince Dec 14, 2019 Accepting new patients

Locations

120 Highland Center Dr
Columbia, SC 29203
Phone (803) 254-4699

9267 Medical Plaza Dr
Ste G
North Charleston, SC 29406
Phone 84321698703

279 E Kennedy St
Spartanburg, SC 29302
Phone (864) 583-0053

176 McSwain Dr
West Columbia, SC 29169
Phone (803) 767-4465

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1104092204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9267 MEDICAL PLAZA DR",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294069139",
            "telephone_number": "843-797-3636",
            "fax_number": "843-797-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 MCSWAIN DR",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694825",
            "telephone_number": "843-797-3636",
            "fax_number": "843-797-3637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Highland Center Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292039127",
            "country_code": "US",
            "telephone_number": "843-797-3636",
            "fax_number": "843-797-3637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATCHLEY",
        "first_name": "MICHAEL",
        "middle_name": "CHAD",
        "name_suffix": "Sr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-08",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.