MCLEOD HEALTH CLARENDON (NPI# 1144875774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144875774 |
| Entity Type | Organization |
| Organization Name | MCLEOD HEALTH CLARENDON |
| Other Organization Name | MCLEOD FAMILY MEDICINE-JOHNSONVILLE |
| Practice Address |
355 S Georgetown Hwy Johnsonville SC 29555-8083 |
| Mailing Address |
Po Box 100567 Florence SC 29502-0567 |
| Practice Telephone | 8433802000 |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2019-08-14 |
| Authorized Official Name | SAMUEL FULTON ERVIN III (SR VICE PRESIDENT AND CFO) |
| Authorized Official Telephone | 8437772910 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | RHC176 | 05 | |
| SC | PTAN | 42-8989 | 01 |
| SC | GP2568 | 05 |
| Other Name | Type Code |
|---|---|
| McLeod Family Medicine-Johnsonville | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326693953 | Mcleod Health Clarendon | Family Medicine | 512 Nelson Blvd Ste 200, Kingstree, SC 29556-4027 | 2019-08-09 |
| 1003461773 | Mcleod Health Clarendon | Family Medicine | 755 E Smith St, Timmonsville, SC 29161-9430 | 2019-08-08 |
| 1669925624 | Mcleod Health Clarendon | Ambulance | 10 E Hospital St, Manning, SC 29102-3153 | 2016-07-26 |
| 1508218793 | Mcleod Health Clarendon | Emergency Medicine | 10 E Hospital St, Manning, SC 29102-3153 | 2016-07-12 |
| 1497104525 | Mcleod Health Clarendon | Family Medicine | 22 Bozard St, Manning, SC 29102-2935 | 2016-06-09 |
| 1316396377 | Mcleod Health Clarendon | Medicare Defined Swing Bed Unit | 10 E Hospital St, Manning, SC 29102-3153 | 2016-06-09 |
| 1962851097 | Mcleod Health Clarendon | Family Medicine | 200 E Hospital St, Manning, SC 29102-3160 | 2016-06-09 |
| 1528417649 | Mcleod Health Clarendon | Family Medicine | 944 Smith Street, Turbeville, SC 29162 | 2016-06-09 |
| 1851740989 | Mcleod Health Clarendon | Clinic/Center | 1056 Felton St, Summerton, SC 29148-7169 | 2016-06-09 |
| 1497103618 | Mcleod Health Clarendon | Obstetrics & Gynecology | 50 E Hospital St, Suite 4, Manning, SC 29102-3149 | 2016-05-27 |
| Street Address |
355 S GEORGETOWN HWY |
| City | JOHNSONVILLE |
| State | SC |
| Zip Code | 29555-8083 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710437702 | Angela Denise Saxon | Nurse Practitioner | 355 S Georgetown Hwy, Johnsonville, SC 29555-8083 | 2016-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518355080 | Carol A. Baker, Dmd, Pa | Clinic/Center | 144 E. Broadway St, Johnsonville, SC 29555 | 2015-01-06 |
| 1275871345 | Florence County School District Five | Skilled Nursing Facility | 156 East Marion Street, Johnsonville, SC 29555 | 2013-01-24 |
| 1295073559 | Florence School District Five | Local Education Agency (LEA) | 156 East Marion St., Johnsonville, SC 29555 | 2013-01-22 |
| 1073802633 | Johnsonville Adult Day Center | Non-emergency Medical Transport (VAN) | 351 S. Midway Highway, Johnsonville, SC 29555 | 2011-04-05 |
| 1235257734 | Johnsonville Rescue Squad and Ambulance Service Inc | Ambulance | 207 East Broadway St, Johnsonville, SC 29555 | 2007-03-26 |
| 1114006897 | Florence County School District Five | Clinic/Center | 237 S. Georgetown Hwy, Johnsonville, SC 29555 | 2006-11-03 |
| 1124119342 | Derrick Allan Wall | Pharmacist | 239 Stuckey St, Johnsonville, SC 29555 | 2006-09-27 |
| 1245321363 | Wall Drugs of Johnsonville, Inc. | Pharmacy | 239 Stuckey Street, Johnsonville, SC 29555 | 2006-09-27 |
| 1770682312 | Lower Florence County Hospital | Clinic/Center | 625 S Georgetown Hwy, Johnsonville, SC 29555 | 2006-09-21 |
| 1912001645 | Mcleod Physician Associates II | Clinic/Center | 355 South Georgetown Highway, Johnsonville, SC 29555 | 2006-09-12 |
| Find all providers in zip 29555 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114006897 | Florence County School District Five | Clinic/Center | 237 S. Georgetown Hwy, Johnsonville, SC 29555 | 2006-11-03 |
| 1770682312 | Lower Florence County Hospital | Clinic/Center | 625 S Georgetown Hwy, Johnsonville, SC 29555 | 2006-09-21 |
| 1912001645 | Mcleod Physician Associates II | Clinic/Center | 355 South Georgetown Highway, Johnsonville, SC 29555 | 2006-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508482050 | The Palmetto Clinics, LLC | Clinic/Center | 463 Calhoun Ave Ste A-2, Greenwood, SC 29649-2063 | 2020-06-21 |
| 1962969154 | The Palmetto Palace | Clinic/Center | 217 Flat St E, Allendale, SC 29810-4647 | 2019-02-25 |
| 1972014652 | Mcleod Physician Associates II | Clinic/Center | 1040 Marlboro Way Ste 1, Bennettsville, SC 29512-2494 | 2017-10-20 |
| 1508377284 | Mcleod Physician Associates II | Clinic/Center | 1076 Marlboro Way Ste 3, Bennettsville, SC 29512-2495 | 2017-10-20 |
| 1154786960 | R Dale Padgett Md Pa | Clinic/Center | 1727 Villagepark Dr, Orangeburg, SC 29118 | 2015-12-21 |
| 1043602428 | Greenville Health System | Clinic/Center | 208 Frontage Rd Ste 1, Clemson, SC 29631-1671 | 2015-02-23 |
| 1114204153 | Mcleod Physician Associates II | Clinic/Center | 5260 Highway 9, Green Sea, SC 29545-4930 | 2011-11-04 |
| 1700160157 | Mackey Family Practice, Pa | Clinic/Center | 8351 Charlotte Hwy, Suite 200, Indian Land, SC 29707-6552 | 2011-10-04 |
| 1588943021 | Edisto Regional Health Services Inc. | Clinic/Center | 185 Mcgee St, Bamberg, SC 29003-1154 | 2011-08-16 |
| 1124307509 | Coastal Carolina Medical Center, Inc | Clinic/Center | 10911 N Jacob Smart Blvd, D, Ridgeland, SC 29936-2729 | 2011-08-16 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSONVILLE |
| Zip Code | 29555 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.