NPIMap

Organization Active NPI

McLeod Physician Associates II

Doing business as McLeod Dialysis Access

  • Nephrology Physician
  • Loris, SC
National Provider Identifier
1013287952
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
MCLEOD PHYSICIAN ASSOCIATES II
Doing business as
McLeod Dialysis Access
Practice address
3112 Casey St
Loris, SC 29569-2808
Phone
(843) 716-8940
Fax
(843) 716-9760
NPI assigned
Jan 10, 2012
Last updated
Oct 10, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MCLEOD HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X

Addresses

Primary practice location

3112 Casey St
Loris, SC 29569-2808

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 777-7042

Other practice location 1

107 McLeod Health Blvd Ste 202
Myrtle Beach, SC 29579-4477
Phone (843) 716-8940

Other names 1

  • McLeod Dialysis Access Doing business as

National Provider Directory

National Provider Directory
Tax ID family
McLeod Physician Associates138 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

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

View all 16

Locations

220 Roper Mountain Road Ext
Greenville, SC 29615
Phone (864) 242-1163

NPI Registry JSON

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1013287952",
    "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": "843-777-7042",
            "fax_number": "843-777-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3112 CASEY ST",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "295692808",
            "telephone_number": "843-716-8940",
            "fax_number": "843-716-9760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 McLeod Health Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295794477",
            "country_code": "US",
            "telephone_number": "843-716-8940",
            "fax_number": "843-716-9760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MCLEOD PHYSICIAN ASSOCIATES II",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCLEOD HEALTH",
        "enumeration_date": "2012-01-10",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "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": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McLeod Dialysis Access",
            "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 Oct 10, 2023; 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.