NPIMap

Organization Active NPI

Pain Specialists of Charleston PA

  • Interventional Pain Medicine Physician
  • North Charleston, SC
National Provider Identifier
1760636856
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
16626 Issued in SC
Legal business name
PAIN SPECIALISTS OF CHARLESTON PA
Practice address
2695 Elms Plantation Blvd Ste a
North Charleston, SC 29406-7132
Phone
(843) 818-1181
NPI assigned
Nov 17, 2008
Organization subpart
Yes
Parent organization
PAIN SPECIALIST OF CHARLESTON PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Authorized official

Name
Mr. Edward M Tavel, MSNPI 1508833468
Title
President
Phone
(843) 818-1181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X 16626 SC Primary

Addresses

Primary practice location

2695 Elms Plantation Blvd Ste a
North Charleston, SC 29406-7132

Mailing address

2695 Elms Plantation Blvd Ste a
North Charleston, SC 29406-7132
Phone (843) 818-1181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090224000652 SC Part B Supplier - Clinic/Group Practice 6002971165 Receives reassigned benefits from 35 practitioners
Practice locations: Beaufort, SC; Pawleys Island, SC; North Charleston, SC; Columbia, SC
O20150728004305 SC DME Supplier - Physician - Anesthesiology 6002971165 Practice locations: North Charleston, SC

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Pain Specialists Charleston

Locations

135 Sea Island Pkwy
Beaufort, SC 29907
Phone (843) 818-1181

52 Monckton Blvd
Columbia, SC 29206

4875 Forest Dr
Columbia, SC 29206

2675 Elms Plantation Blvd
Ste A
North Charleston, SC 29406

150 Wall St
Pawleys Island, SC 29585
Phone (843) 818-1181

Practitioners & affiliated clinicians

Practitioners 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628640000000",
    "number": "1760636856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ELMS PLANTATION BLVD STE A",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294067132",
            "telephone_number": "843-818-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2695 ELMS PLANTATION BLVD STE A",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294067132",
            "telephone_number": "843-818-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN SPECIALISTS OF CHARLESTON PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PAIN SPECIALIST OF CHARLESTON PA",
        "enumeration_date": "2008-11-17",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A",
        "authorized_official_last_name": "TAVEL",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-818-1181",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "SC",
            "license": "16626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.