NPIMap

Organization Active NPI

McLeod Regional Medical Center of the Pee Dee, Inc

  • Rheumatology Physician
  • Myrtle Beach, SC
National Provider Identifier
1407613987
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC
Practice address
115 McLeod Health Blvd.
Suite 201
Myrtle Beach, SC 29579-4477
Phone
(843) 366-3060
Fax
(843) 366-3069
NPI assigned
Mar 1, 2024
Organization subpart
Yes
Parent organization
MCLEOD HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 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
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X Primary

Addresses

Primary practice location

115 McLeod Health Blvd.
Suite 201
Myrtle Beach, SC 29579-4477

Mailing address

PO Box 601743
Charlotte, NC 28260-1743
Phone (843) 366-3060

Other names 1

  • McLeod Rheumatology Seacoast Doing business as

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

NPI Registry JSON

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

{
    "created_epoch": "1709251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1407613987",
    "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": "843-366-3060",
            "fax_number": "843-777-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MCLEOD HEALTH BLVD.",
            "address_2": "SUITE 201",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794477",
            "telephone_number": "843-366-3060",
            "fax_number": "843-366-3069"
        }
    ],
    "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": "2024-03-01",
        "last_updated": "2024-03-01",
        "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": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McLeod Rheumatology Seacoast",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 1, 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.