NPIMap

Organization Active NPI

Trident Pain Center, PA

  • Pain Medicine (Anesthesiology) Physician
  • Mt Pleasant, SC
National Provider Identifier
1235533480
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
TRIDENT PAIN CENTER, PA
Practice address
1341 Old Georgetown Rd
Mt Pleasant, SC 29464-7307
Phone
(843) 797-3636
Fax
(843) 797-3637
NPI assigned
Oct 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

1341 Old Georgetown Rd
Mt Pleasant, SC 29464-7307

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
GP3479MedicaidSC

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": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1235533480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9267 MEDICAL PLAZA DR STE G",
            "city": "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": "1341 OLD GEORGETOWN RD",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294647307",
            "telephone_number": "843-797-3636",
            "fax_number": "843-797-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIDENT PAIN CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3479",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.