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Organization Active NPI

McLeod Regional Medical Center of the Pee Dee, Inc

Doing business as McLeod Family Medicine South

  • Family Medicine Physician
  • Florence, SC
National Provider Identifier
1184481897
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC
Doing business as
McLeod Family Medicine South
Practice address
611 2ND Loop Rd
Florence, SC 29505-2820
Phone
(843) 777-9460
Fax
(843) 678-3610
NPI assigned
Feb 29, 2024
Last updated
Feb 29, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MCLEOD HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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 & Cfo
Phone
(843) 777-2910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

611 2ND Loop Rd
Florence, SC 29505-2820

Mailing address

PO Box 601743
Charlotte, NC 28260-1743
Phone (843) 777-9460

Other names 1

  • McLeod Family Medicine South Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wilson Emer Phys39 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

NPI Registry JSON

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1184481897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601743",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601743",
            "telephone_number": "843-777-9460",
            "fax_number": "843-777-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 2ND LOOP RD",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295052820",
            "telephone_number": "843-777-9460",
            "fax_number": "843-678-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCLEOD HEALTH",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "ERVIN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "FULTON",
        "authorized_official_title_or_position": "SR. VP & CFO",
        "authorized_official_telephone_number": "843-777-2910",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McLeod Family Medicine South",
            "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 Feb 29, 2024; 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.