McLeod Regional Medical Center of the Pee Dee, Inc
Organization Active NPI Emergency Medical Services (Emergency Medicine) Physician · Florence, SC
NPI 1154371433 · NPPES record last updated Mar 19, 2024
Key facts
- NPI
- 1154371433
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician 207PE0004X
- Legal business name
- MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC
- Practice address
- 555 E Cheves St
Florence, SC 29506-2617 - Phone
- (843) 777-2000
- Fax
- (843) 777-5035
- NPI assigned
- May 10, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- MCLEOD HEALTH
Authorized official
- Name
- Samuel Fulton Ervin III
- Title
- Senior VP and Cfo
- Phone
- (843) 777-2910
Owned or controlled facilities with NPI records 1
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 6
Practitioners 874
-
Olayinka Afolabi, M.D.
-
Jeremy Li Agostinho, M.D.
-
Roberto Aguilera, M.D.
-
Tonya Alexander, FNP-BC
-
Chelsea Morgan Atkinson, PA-C
-
Samuel Kwakye Ayeh, MD,MPH
-
Kazim Aykent, MD
-
Rajesh Bajaj, M.D.
-
Ravneet Bajwa, M.D.
-
Mary Balarie Baker, APRN
-
Lauren Lynn Bapst, PA-C
-
Laura Baxley, FNP-C
-
Donald A Behling, MD
-
Orran Coretta Bethea, FNP
-
William R Betz, MD
-
Alan M Blaker, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Hospice of the Pee Dee |
Hospice | 5% Or Greater Direct Ownership Interest | Jul 3, 2003 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031126000251 | SC | Part B Supplier - Clinic/Group Practice | 7416851852 |
Receives reassigned benefits from 828 practitioners 2 other NPIs on this enrollment Practice locations: Little River, SC; Sumter, SC; North Myrtle Beach, SC; Myrtle Beach, SC; Loris, SC; Florence, SC; Darlington, SC |
National Provider Directory
Locations
800 E Cheves St
Ste 310
Florence, SC 29506
Phone (843) 679-7272
1001 W Sumter St
Florence, SC 29501
Phone (843) 664-4158
4000 Highway 9 E
Ste 250
Little River, SC 29566
Phone (843) 366-3891
3980 Highway 9 E
Ste 300
Little River, SC 29566
Phone (843) 366-3891
3793 McDowell Ln
Ste 200
Little River, SC 29566
Phone (843) 390-0877
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | |||
| Registered Dietitian |
133V00000X | |||
| Emergency Medical Services (Emergency Medicine) Physician |
207PE0004X | Yes | ||
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | |||
| Critical Care Medicine (Internal Medicine) Physician |
207RC0200X | |||
| Endocrinology, Diabetes & Metabolism Physician |
207RE0101X | |||
| Gastroenterology Physician |
207RG0100X | |||
| Hematology & Oncology Physician |
207RH0003X | |||
| Interventional Cardiology Physician |
207RI0011X | |||
| Pediatric Endocrinology Physician |
2080P0205X | |||
| Neurology Physician |
2084N0400X | |||
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | |||
| Certified Registered Nurse Anesthetist |
367500000X |
Addresses
Primary practice location
555 E Cheves St
Florence, SC 29506-2617
Mailing address
PO Box 100567
Florence, SC 29502-0567
Phone (843) 777-5802
Other practice location 1
3980 Highway 9 E Ste 300
Little River, SC 29566-8165
Phone (843) 366-3891
Other practice location 2
401 E Cheves St Ste 201
Florence, SC 29506-2615
Phone (843) 777-7951
Other practice location 3
701 Cashua Ferry Rd
Darlington, SC 29532-8488
Phone (843) 777-1100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 400514 | Medicaid | SC |
Other names
- CBO MRMC EMERGENCY
Other providers in Florence, SC
- McLeod Regional Health Center
- McLeod Regional Medical Center of Pee Dee Inc
- McLeod Regional Medical Center of the Pee Dee
- McLeod Regional Medical Center of the Pee Dee Inc
- McLeod Regional Medical Center of the Pee Dee, Inc
- McLeod Regional Medical Center of the Pee Dee, Inc
- McLeod Regional Medical Center of the Pee Dee, Inc
- McLeod Regional Medical Center of the Pee Dee, Inc
- McLeod Regional Medical Center of the Pee Dee, Inc
- McLeod Regional Medical Center of the Pee Dee, Inc
All providers in Florence, SC · Emergency Medical Services (Emergency Medicine) Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.