NPIMap

Organization Active NPI

McLeod Physician Associates II

Doing business as Pee Dee Surgical Group

  • Surgery Physician
  • Florence, SC
National Provider Identifier
1619994233
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MCLEOD PHYSICIAN ASSOCIATES II
Doing business as
Pee Dee Surgical Group
Practice address
800 E Cheves St
Ste 260
Florence, SC 29506-2652
Phone
(843) 665-7941
Fax
(843) 665-1257
NPI assigned
Jul 17, 2006
Last updated
Jun 7, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MCLEOD HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Authorized official

Name
Mr. Kenneth D. Beasley
Title
Sr VP
Phone
(843) 777-7010

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X NU
Nurse Practitioner 363L00000X NU
Surgery Physician 208600000X NU Primary
Vascular Surgery Physician 2086S0129X NU

Addresses

Primary practice location

800 E Cheves St
Ste 260
Florence, SC 29506-2652

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 665-7941

Other identifiers 1

IdentifierTypeStateIssuer
GP1701MedicaidSC

Other names 1

  • Pee Dee Surgical Group Doing business as

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
42D2136861Pee Dee Surgical Group800 East Cheves Street, Suite 260, Florence, SC 29506Certificate of waiverSep 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
McLeod Physician Associates138 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

800 E Cheves St
Ste 260
Florence, SC 29506
Phone (803) 665-7941

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1619994233",
    "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": "843-665-7941",
            "fax_number": "843-665-1257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CHEVES ST",
            "address_2": "STE 260",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062652",
            "telephone_number": "843-665-7941",
            "fax_number": "843-665-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEOD PHYSICIAN ASSOCIATES II",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCLEOD HEALTH",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "BEASLEY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "SR VP",
        "authorized_official_telephone_number": "843-777-7010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1701",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pee Dee Surgical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pee Dee Surgical Group",
            "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 Jun 7, 2022; 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.