NPIMap

Organization Active NPI

McLeod Physician Associates II

Doing business as McLeod Cardiothoracic Surgical Associates

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Florence, SC
National Provider Identifier
1104899145
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
MCLEOD PHYSICIAN ASSOCIATES II
Doing business as
McLeod Cardiothoracic Surgical Associates
Practice address
101 William H Johnson St Ste 370
Florence, SC 29506-2769
Phone
(437) 777-0208
Fax
(843) 664-9545
NPI assigned
Feb 9, 2006
Last updated
Jun 3, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MCLEOD HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 3, 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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X Primary
Surgical Physician Assistant 363AS0400X

Addresses

Primary practice location

101 William H Johnson St Ste 370
Florence, SC 29506-2769

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 664-0221

Other identifiers 1

IdentifierTypeStateIssuer
GP3603MedicaidSC

Other names 1

  • McLeod Cardiothoracic Surgical 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 24

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

View all 24

Locations

101 S Ravenel St
Ste 207
Florence, SC 29506

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654214400000",
    "number": "1104899145",
    "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": "843-664-0221",
            "fax_number": "843-664-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WILLIAM H JOHNSON ST STE 370",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062769",
            "telephone_number": "437-777-0208",
            "fax_number": "843-664-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEOD PHYSICIAN ASSOCIATES II",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCLEOD HEALTH",
        "enumeration_date": "2006-02-09",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "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": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3603",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McLeod Cardiothoracic Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McLeod Cardiothoracic Surgical Associates",
            "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 Jun 3, 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.