NPIMap

Organization Active NPI

McLeod Physician Associates II

  • Family Medicine Physician
  • North Myrtle Beach, SC
National Provider Identifier
1609460443
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MCLEOD PHYSICIAN ASSOCIATES II
Practice address
2021 N Myrtle Point Blvd Ste 101
North Myrtle Beach, SC 29582-2224
Phone
(843) 366-2900
Fax
(843) 366-2450
NPI assigned
Feb 23, 2021
Organization subpart
Yes
Parent organization
MCLEOD HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Authorized official

Name
Kenneth D. Beasley
Title
Senior Vice President
Phone
(843) 777-7010

Specialties & licenses 2

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

Addresses

Primary practice location

2021 N Myrtle Point Blvd Ste 101
North Myrtle Beach, SC 29582-2224

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 646-8923

Other names 1

  • McLEOD PRIMARY CARE NORTH MYRTLE BEACH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
McLeod Physician Associates 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

Locations

108 Finnegan Ct
Myrtle Beach, SC 29579
Phone (843) 903-9993

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
42D2217107McLeod Primary Care North Myrtle Beach2021 North Myrtle Point Blvd,, North Myrtle Beach, SC 29582Certificate of waiverMar 17, 2027

NPI Registry JSON

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719360000000",
    "number": "1609460443",
    "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": "843-646-8923",
            "fax_number": "843-777-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 N MYRTLE POINT BLVD STE 101",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295822224",
            "telephone_number": "843-366-2900",
            "fax_number": "843-366-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEOD PHYSICIAN ASSOCIATES II",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCLEOD HEALTH",
        "enumeration_date": "2021-02-23",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A",
        "authorized_official_last_name": "BEASLEY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "D.",
        "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": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McLEOD PRIMARY CARE NORTH MYRTLE BEACH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.