NPIMap

Organization Active NPI

Trident Pain Center LLC

  • Pain Medicine Physician
  • Walterboro, SC
National Provider Identifier
1194138255
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
19839 Issued in SC
Legal business name
TRIDENT PAIN CENTER LLC
Practice address
205 Eddie Chasteen Dr
Walterboro, SC 29488-5728
Phone
(843) 797-3636
NPI assigned
Jun 6, 2014
Organization subpart
No

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X 19839 SC Primary

Addresses

Primary practice location

205 Eddie Chasteen Dr
Walterboro, SC 29488-5728

Mailing address

9267 Medical Plaza Dr Ste G
North Charleston, SC 29406-9139

National Provider Directory

National Provider Directory
Tax ID family
Trident Pain Center LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1194138255",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 EDDIE CHASTEEN DR",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294885728",
            "telephone_number": "843-797-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIDENT PAIN CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-06",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "NOLAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "843-797-3636",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "SC",
            "license": "19839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walterboro, 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.