Town of Moncks Corner

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

Legal business name

TOWN OF MONCKS CORNER

Practice address

116 Carolina Ave
Moncks Corner, SC 29461-3735

Phone

(843) 719-7990

NPI assigned

Sep 13, 2021

Organization subpart

No

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

Authorized official

Name

Robert Gass, EMT

Title

Fire Chief

Phone

(843) 719-7991

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Moncks Corner Fire Department Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631491200000",
    "number": "1134898000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 CAROLINA AVE",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613735",
            "telephone_number": "843-719-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 CAROLINA AVE",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613735",
            "telephone_number": "843-719-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF MONCKS CORNER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-03-31",
        "status": "A",
        "authorized_official_last_name": "GASS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "843-719-7991",
        "authorized_official_credential": "EMT"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMS AGENCY ID",
            "identifier": "612",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moncks Corner Fire Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cawana Michelle Tisdale
• Margaret McSwain Tolar, PA-C
• Tawanda Tolliver-McHenry, M.A.
• Phillip William Tolman, PA
• Glenda Reed Torricelli, M.D.
• Trans North Aviation LTD
• Trident Emergency Physicians LLC
• Trident Medical Center, LLC
• Trident Pain Center LLC
• Jason Kenneth Trigiani, PA-C

• Emergency Medical Services (Emergency Medicine) Physician in Moncks Corner, SC
• Providers in Moncks Corner, SC by specialty
• Emergency Medical Services (Emergency Medicine) Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.