NPIMap

Organization Active NPI

Trident Medical Services D/B/a Trident Senior Health Center

Doing business as Trident Senior Health Center

  • Primary Care Clinic/Center
  • Charleston, SC
National Provider Identifier
1740394071
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
TRIDENT MEDICAL SERVICES D/B/A TRIDENT SENIOR HEALTH CENTER
Doing business as
Trident Senior Health Center
Practice address
9302 Medical Plaza Dr
Suite C
Charleston, SC 29406-9142
Phone
(843) 797-0416
Fax
(843) 847-4477
NPI assigned
Aug 17, 2006
Last updated
Mar 24, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
TRIDENT MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Authorized official

Name
Ms. Kimberlie Denmark, RN
Title
Director
Phone
(843) 797-0416

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X

Addresses

Primary practice location

9302 Medical Plaza Dr
Suite C
Charleston, SC 29406-9142

Mailing address

9302 Medical Plaza Dr
Suite C
Charleston, SC 29406-9142
Phone (843) 797-0416

Other identifiers 1

IdentifierTypeStateIssuer
GP1196MedicaidSC

Other names 1

  • Trident Senior Health Center Doing business as

National Provider Directory

National Provider Directory
Part of
Trident Medical Center LLC

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1740394071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9302 MEDICAL PLAZA DR",
            "address_2": "SUITE C",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069142",
            "telephone_number": "843-797-0416",
            "fax_number": "843-847-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9302 MEDICAL PLAZA DR",
            "address_2": "SUITE C",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069142",
            "telephone_number": "843-797-0416",
            "fax_number": "843-847-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIDENT MEDICAL SERVICES D/B/A TRIDENT SENIOR HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRIDENT MEDICAL CENTER",
        "enumeration_date": "2006-08-17",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "DENMARK",
        "authorized_official_first_name": "KIMBERLIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "843-797-0416",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1196",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trident Senior Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.