NPIMap

Organization Active NPI

McLeod Regional Medical Center of the Pee Dee, Inc

Doing business as McLeod Cardiology Associates Loris

  • Cardiovascular Disease Physician
  • Loris, SC
National Provider Identifier
1902663529
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC
Doing business as
McLeod Cardiology Associates Loris
Practice address
3485 Mitchell St
Loris, SC 29569-2823
Phone
(843) 756-7029
Fax
(843) 756-7033
NPI assigned
Feb 29, 2024
Last updated
Feb 29, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MCLEOD HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 29, 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) 777-2912

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU
Nurse Practitioner 363L00000X NU
Cardiovascular Disease Physician 207RC0000X NU Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X NU
Interventional Cardiology Physician 207RI0011X NU

Addresses

Primary practice location

3485 Mitchell St
Loris, SC 29569-2823

Mailing address

PO Box 601743
Charlotte, NC 28260-1743
Phone (843) 756-7029

Other names 1

  • McLeod Cardiology Associates Loris Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Anesthesia Service39 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": "1709164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1902663529",
    "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": "843-756-7029",
            "fax_number": "843-777-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 MITCHELL ST",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "295692823",
            "telephone_number": "843-756-7029",
            "fax_number": "843-756-7033"
        }
    ],
    "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": "2024-02-29",
        "last_updated": "2024-02-29",
        "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": "843-777-2912",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McLeod Cardiology Associates Loris",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Loris, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 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.