Trident Senior Health Center

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

TRIDENT SENIOR HEALTH CENTER

Practice address

2070 Northbrook Blvd
#A16
Charleston, SC 29406-9252

Phone

(843) 797-0416

NPI assigned

Jun 17, 2006

Organization subpart

No

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

Authorized official

Name

Tim Lloyd

Title

V.P.

Phone

(843) 797-0416

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1467497206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2070 NORTHBROOK BLVD",
            "address_2": "#A16",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069252",
            "telephone_number": "843-797-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 NORTHBROOK BLVD",
            "address_2": "#A16",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069252",
            "telephone_number": "843-797-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIDENT SENIOR HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "LLOYD",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "V.P.",
        "authorized_official_telephone_number": "843-797-0416"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1196",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trident Medical Center, LLC
• Trident Medical Center, LLC
• Trident Medical Services D/B/a Trident Senior Health Center
• Trident Neonatology Services LLC
• Trident Pain Center LLC
• Trident Vision Center Inc
• Mary Victoria Trimble, CRNA
• Trinity Mission of Charleston, LLC
• Samuel Vance Tripp, CRNA
• Nishant Divyang Trivedi, MD

• Geriatric Medicine (Family Medicine) Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Geriatric Medicine (Family Medicine) Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.