NPIMap

Organization Active NPI

McLeod Health Cheraw

  • General Acute Care Hospital
  • Cheraw, SC
National Provider Identifier
1902283740
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
MCLEOD HEALTH CHERAW
Practice address
711 Chesterfield Hwy
Cheraw, SC 29520-7002
Phone
(843) 537-7881
NPI assigned
Apr 30, 2015
Last updated
Feb 25, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
MCLEOD HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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

Authorized official

Name
Samuel F Ervin III
Title
Sr Vice President & Cfo
Phone
(843) 777-2910

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU Primary
Rural Acute Care Hospital 282NR1301X NU

Addresses

Primary practice location

711 Chesterfield Hwy
Cheraw, SC 29520-7002

Mailing address

PO Box 100567
Florence, SC 29502-0567

Other identifiers 3

IdentifierTypeStateIssuer
AL0681MedicaidSC
BL0681MedicaidSC
42-0107OtherSCMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150611001531 SC Part A Provider - Hospital 7911228259 Practice locations: Cheraw, SC; Pageland, SC
O20160404001703 SC Part A Provider - Hospital 7911228259 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cheraw, SC

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1902283740. Details of each certification follow.

Hospital certification: CCN 420107

Legal name
MCLEOD HEALTH CHERAW
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 14, 2015
Last certification
Aug 24, 2022
Beds
59
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Apr 3, 2015 in SC
Enrollment address
711 Chesterfield Hwy
Cheraw, SC 29520-7002
Main/Primary Hospital Location
Hospital subgroups
Acute care

Hospital certification: CCN 42U107

Legal name
MCLEOD HEALTH CHERAW
Organization structure
CorporationNon-profit
Incorporated
Apr 3, 2015 in SC
Enrollment address
711 Chesterfield Hwy
Cheraw, SC 29520-7002
Other Hospital Practice Location
Hospital subgroups
Acute care, Swing-bed approved

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
McLeod Health CherawCCN 420107 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 35

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Willie E Boyd Individual Corporate OfficerBoard of Trustees Jan 1, 2018
Corporate OfficerBoard of Trustees Jan 1, 2021
Frances S Jones Individual Corporate OfficerBoard of Directors Jan 1, 2018
Corporate OfficerBoard of Trustees Jan 1, 2021
Ashley Brady Individual Corporate Officer Jan 1, 2018
Corporate OfficerBoard of Trustees Jan 1, 2021
William N Boulware Individual Corporate OfficerBoard of Trustees Jan 1, 2018
Corporate OfficerBoard of Trustees Jan 1, 2021
Allie E Brooks Individual Corporate OfficerBoard of Trustees Dec 31, 2020
Corporate OfficerBoard of Trustees Jan 1, 2021
Shelia Rollins Individual W-2 Managing EmployeeManger of Net Revenue Jan 1, 2025
W-2 Managing EmployeeNet Revenue MGR Jan 1, 2025
Benjamin T Zeigler Individual Corporate OfficerBoard of Trustees Jan 1, 2018
Christian Soura Individual Corporate OfficerSenior Vice President and Chief Apr 1, 2025
Corporate OfficerSr VP and Cfo Apr 1, 2025
Ronald M Fowler Individual Corporate OfficerBoard of Trustees Jan 1, 2018
Corporate OfficerBoard of Trustees Jan 1, 2021
Dudley B. Harrington Individual Corporate OfficerVP of Business Operations Jan 1, 2018
Virginia L Clyburn-Ipock Individual Corporate OfficerBoard of Trustees Jun 1, 2021
Jeannette Glenn Individual Corporate OfficerBoard of Trustees Jan 1, 2018
Corporate OfficerBoard of Trustees Jan 1, 2021
McLeod Health Organization, Florence, SC Non-profit 5% Or Greater Direct Ownership Interest Jun 22, 2015 100%
Operational/Managerial Control Jun 22, 2015 100%
Samuel F Ervin Individual Corporate OfficerSVP and Cfo Jun 22, 2015 100%
Operational/Managerial ControlSVP and Cfo Jun 22, 2015 100%
Bren Lowe Individual W-2 Managing EmployeeVP/Administrator Jan 1, 2021
Raymond Clark Individual Corporate OfficerBoard of Trustees Dec 31, 2020
Hugh S Blair Individual Corporate OfficerBoard of Trustees Jan 1, 2018
Corporate OfficerBoard of Trustees Jan 1, 2021
Mary Anderson Individual Corporate OfficerBoard of Trustees Jan 1, 2018
Corporate OfficerBoard of Trustees Jan 1, 2021
Tracy Ray Individual Corporate OfficerBoard of Trustees Jan 1, 2018
Corporate OfficerBoard of Trustees Jan 1, 2021
Donna Isgett Individual Corporate OfficerPresident and Ceo Mar 1, 2021
Corporate OfficerPresident & Cfo Mar 1, 2021
Tarek M Bishara Individual Corporate OfficerBoard of Trustees Jan 1, 2018
Corporate OfficerBoard of Trustees Jan 1, 2021
Beverly Hazelwood Individual Corporate OfficerBoard of Trustees Jan 1, 2018
Corporate OfficerBoard of Trustees Jan 1, 2021
Amy Fisher Individual Corporate OfficerBoard of Trustees Jun 1, 2021
Amit Vyankatesh Pande Individual Corporate OfficerBoard of Trustees Jun 1, 2021
Frank V Boulineau Individual Corporate OfficerBoard of Trustees Jan 1, 2018
Corporate OfficerBoard of Trustees Jan 1, 2021
Patrick Kerry Denton Individual Corporate OfficerBoard of Trustees Jan 1, 2018
Corporate OfficerBoard of Trustees Jan 1, 2021
Frank J Brand Individual Corporate OfficerBoard of Trustees Jan 1, 2018
Corporate OfficerBoard of Trustees Jan 1, 2021
James C Smith Individual Corporate OfficerBoard of Trustees Dec 31, 2020
Corporate OfficerBoard of Trustees Jan 1, 2021
Carl J Chelen Individual Corporate OfficerChief of Staff Jan 1, 2022
John R Braddy Individual Corporate OfficerBoard of Trustees Jan 1, 2018
J Douglas Lynn Individual Corporate OfficerBoard of Trustees Jan 1, 2025
David Oren Atkinson Individual Corporate OfficerBoard of Trustees Jan 1, 2025
Matthew Prince Individual Corporate OfficerBoard of Trustees Jan 1, 2025
John M Scott Individual Corporate OfficerBoard of Trustees Jan 1, 2025
Carmen Piccolo Individual Corporate OfficerBoard of Trustees Jan 1, 2025

Owners & managing parties with NPI records 9

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
McLeod Family Medicine-DarlingtonDarlington, SC, CCN 423416 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 17

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 17

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 218

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 218

NPI Registry JSON

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551052800000",
    "number": "1902283740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100567",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295020567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 CHESTERFIELD HWY",
            "city": "CHERAW",
            "state": "SC",
            "postal_code": "295207002",
            "telephone_number": "843-537-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEOD HEALTH CHERAW",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCLEOD HEALTH",
        "enumeration_date": "2015-04-30",
        "last_updated": "2019-02-25",
        "status": "A",
        "authorized_official_last_name": "ERVIN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "SR VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "843-777-2910",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AL0681",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BL0681",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "42-0107",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheraw, SC

Sources for this page

Verify at the official NPI Registry.