Trident Pain Center LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

TRIDENT PAIN CENTER LLC

Practice address

108 N Highway 52
Moncks Corner, SC 29461-3910

Phone

(843) 797-3636

Fax

(843) 797-3637

NPI assigned

Sep 18, 2013

Organization subpart

Yes

Parent organization

TRIDENT PAIN CENTER LLCAs reported in NPPES

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

Authorized official

Name

Dr. Joseph Edward Nolan, MD

Title

Medical Director

Phone

(843) 797-3636

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Trident Pain Center LLC

  • Interventional Pain Medicine Physician
  • N Charleston, SC
  • NPI 1801992961

  O20040318001454

  Same enrollment

Part of

Trident Pain Center LLC

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carolyn Ann Koster Hyatt, PA-C

  • Physician Assistant
  • North Charleston, SC
  • NPI 1073819249
  NPD
• Jessica Pringle, APRN

  • Nurse Practitioner
  • Columbia, SC
  • NPI 1902761786
  NPD
• Stephen P Gibert Jr., MD

  • Interventional Pain Medicine Physician
  • Rome, GA
  • NPI 1578671517
  NPD

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

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1154757482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9267 MEDICAL PLAZA DR STE G",
            "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": "108 N HIGHWAY 52",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613910",
            "telephone_number": "843-797-3636",
            "fax_number": "843-797-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIDENT PAIN CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRIDENT PAIN CENTER LLC",
        "enumeration_date": "2013-09-18",
        "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_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3479",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glenda Reed Torricelli, M.D.
• Town of Moncks Corner
• Trans North Aviation LTD
• Trident Emergency Physicians LLC
• Trident Medical Center, LLC
• Jason Kenneth Trigiani, PA-C
• Trips Chiropractic
• True Vine Home Care Agency LLC
• Britton Livingston Tucker, PA
• Christopher Anthony Tucker, RN

• Pain Medicine (Anesthesiology) Physician in Moncks Corner, SC
• Providers in Moncks Corner, SC by specialty
• Pain Medicine (Anesthesiology) Physician in South Carolina

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.