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Organization Active NPI

McLeod Physician Associates II

Doing business as McLeod Primary Care Bennettsville

  • Family Medicine Physician
  • Bennettsville, SC
National Provider Identifier
1497134852
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MCLEOD PHYSICIAN ASSOCIATES II
Doing business as
McLeod Primary Care Bennettsville
Practice address
1040 Marlboro Way
Suite 1
Bennettsville, SC 29512-2494
Phone
(843) 479-5890
Fax
(843) 479-3524
NPI assigned
May 19, 2015
Last updated
May 19, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
MCLEOD HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 19, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dane P. Ficco
Title
Senior Vice President
Phone
(843) 777-7010

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X SC Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X SC

Addresses

Primary practice location

1040 Marlboro Way
Suite 1
Bennettsville, SC 29512-2494

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 777-7162

Other names 1

  • McLeod Primary Care Bennettsville 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

NPI Registry JSON

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431993600000",
    "number": "1497134852",
    "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": "843-777-7162",
            "fax_number": "843-777-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 MARLBORO WAY",
            "address_2": "SUITE 1",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295122494",
            "telephone_number": "843-479-5890",
            "fax_number": "843-479-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEOD PHYSICIAN ASSOCIATES II",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCLEOD HEALTH",
        "enumeration_date": "2015-05-19",
        "last_updated": "2015-05-19",
        "status": "A",
        "authorized_official_last_name": "FICCO",
        "authorized_official_first_name": "DANE",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "843-777-7010"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McLeod Primary Care Bennettsville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bennettsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; 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.