NPIMap

Organization Active NPI

McLeod Occupational Health, LLC

  • Occupational Medicine Physician
  • Myrtle Beach, SC
National Provider Identifier
1235844598
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
Legal business name
MCLEOD OCCUPATIONAL HEALTH, LLC
Practice address
907 Startek Dr
Myrtle Beach, SC 29579-4471
Phone
(843) 646-8400
NPI assigned
Jan 20, 2023
Last updated
Jan 20, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MCLEOD HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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 Vice President and Cfo
Phone
(843) 777-2910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X NU Primary

Addresses

Primary practice location

907 Startek Dr
Myrtle Beach, SC 29579-4471

Mailing address

907 Startek Dr
Myrtle Beach, SC 29579-4471
Phone (843) 646-8400

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
42D2224025McLeod Occupational Health-Carolina Forest907 Startek Drive, Myrtle Beach, SC 29579Certificate of waiverMay 10, 2027

National Provider Directory

National Provider Directory
Tax ID family
McLeod Occupational Health LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1674172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1235844598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 STARTEK DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794471",
            "telephone_number": "843-646-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 STARTEK DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794471",
            "telephone_number": "843-646-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEOD OCCUPATIONAL HEALTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCLEOD HEALTH",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "ERVIN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "FULTON",
        "authorized_official_title_or_position": "SR VICE PRESIDENT AND CFO",
        "authorized_official_telephone_number": "843-777-2910",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.