NPIMap

Organization Active NPI

McLeod Regional Medical Center of the Pee Dee, Inc

  • Internal Medicine Physician
  • Florence, SC
National Provider Identifier
1073314852
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC
Practice address
101 William H Johnson St Ste 200-B
Florence, SC 29506-2763
Phone
(843) 777-5735
Fax
(843) 777-2804
NPI assigned
Mar 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Authorized official

Name
Samuel Fulton Ervin III
Title
Sr VP and Cfo
Phone
(843) 777-2010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

101 William H Johnson St Ste 200-B
Florence, SC 29506-2763

Mailing address

101 William H Johnson St Ste 200-B
Florence, SC 29506-2763
Phone (843) 777-5735

Other names 1

  • MCLEOD INTERNAL MEDICINE RESIDENCY CENTER Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2322610McLeod Internal Medicine Residency Center101 William Johnson Street, Florence, SC 29506Certificate of waiverApr 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
McLeod Regional Med Ctr39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1742342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1073314852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WILLIAM H JOHNSON ST STE 200-B",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062763",
            "telephone_number": "843-777-5735",
            "fax_number": "843-777-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WILLIAM H JOHNSON ST STE 200-B",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062763",
            "telephone_number": "843-777-5735",
            "fax_number": "843-777-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-19",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "ERVIN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "FULTON",
        "authorized_official_title_or_position": "SR VP AND CFO",
        "authorized_official_telephone_number": "843-777-2010",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCLEOD INTERNAL MEDICINE RESIDENCY CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.