Organization Active NPI

Trident Pain Center P a

  • Pain Medicine (Anesthesiology) Physician
  • Columbia, SC
National Provider Identifier
1104468594
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
TRIDENT PAIN CENTER P A
Practice address
120 Highland Center Dr
Columbia, SC 29203-9127
Phone
(843) 797-3636
Fax
(843) 797-3637
NPI assigned
Oct 17, 2019
Organization subpart
Yes
Parent organization
TRIDENT PAIN CENTER LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Authorized official

Name
Joseph Edward Nolan, MD
Title
Medical Director
Phone
(843) 797-3636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

120 Highland Center Dr
Columbia, SC 29203-9127

Mailing address

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

National Provider Directory

National Provider Directory
Part of
Trident Pain Center LLC

NPI Registry JSON

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1104468594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9267 MEDICAL PLAZA DR STE G",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069139",
            "telephone_number": "843-797-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HIGHLAND CENTER DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292039127",
            "telephone_number": "843-797-3636",
            "fax_number": "843-797-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIDENT PAIN CENTER P A",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRIDENT PAIN CENTER LLC",
        "enumeration_date": "2019-10-17",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "NOLAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "843-797-3636",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.