NPIMap

Organization Active NPI

McLeod Physician Associates II

Doing business as Southern Medical Associates

  • Family Medicine Physician
  • Loris, SC
National Provider Identifier
1003183120
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MCLEOD PHYSICIAN ASSOCIATES II
Doing business as
Southern Medical Associates
Practice address
3418 Casey St
Loris, SC 29569-2904
Phone
(843) 756-7885
Fax
(843) 756-7855
NPI assigned
Nov 17, 2011
Last updated
Jun 7, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MCLEOD HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Authorized official

Name
Kenneth D. Beasley
Title
Senior Vice President
Phone
(843) 777-7010

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X SC Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X SC
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X SC
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X SC

Addresses

Primary practice location

3418 Casey St
Loris, SC 29569-2904

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 777-7122

Other names 1

  • Southern Medical Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
McLeod Physician Assoc II138 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Interoperability endpoints

  • FHIR API: https://epicproxy.et1267.epichosted.com/FHIRProxy/api/FHIR/R4/

NPI Registry JSON

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1003183120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3239",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295023239",
            "telephone_number": "843-777-7122",
            "fax_number": "843-777-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3418 CASEY ST",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "295692904",
            "telephone_number": "843-756-7885",
            "fax_number": "843-756-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEOD PHYSICIAN ASSOCIATES II",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCLEOD HEALTH",
        "enumeration_date": "2011-11-17",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "BEASLEY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "843-777-7010"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Loris, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.