MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC (NPI# 1154371433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154371433 |
| Entity Type | Organization |
| Organization Name | MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC |
| Other Organization Name | CBO MRMC EMERGENCY |
| Practice Address |
555 E Cheves St Florence SC 29506-2617 |
| Mailing Address |
Po Box 100567 Florence SC 29502-0567 |
| Practice Telephone | 8437772000 |
| Practice Fax Number | 8437775035 |
| Mailing Telephone | 8437775802 |
| Mailing Fax Number | 8437775035 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2019-10-29 |
| Authorized Official Name | SAMUEL FULTON ERVIN III (SENIOR VP AND CFO) |
| Authorized Official Telephone | 8437772910 |
| Is Organization Subpart | Y |
| Parent Organization Name | MCLEOD REGIONAL MEDICAL CENTER OF PEE DEE INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 400514 | 05 |
| Other Name | Type Code |
|---|---|
| CBO MRMC EMERGENCY | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3980 Highway 9 E Ste 300, Little River, SC 295668165 | 8433663891 | |
| 401 E Cheves St Ste 201, Florence, SC 295062615 | 8437777951 | |
| 701 Cashua Ferry Rd, Darlington, SC 295328488 | 8437771100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871775841 | Mcleod Regional Medical Center of The Pee Dee, Inc | Pharmacy | 501 E Cheves St Ste D, Florence, SC 29506 | 2007-12-03 |
| 1427004738 | Mcleod Regional Medical Center of The Pee Dee, Inc | Dietitian, Registered | 101 William H Johnson St Ste 290, Florence, SC 29506-2769 | 2006-05-26 |
| 1215991682 | Mcleod Regional Medical Center of The Pee Dee, Inc | Home Health | 300 S Dargan St, Florence, SC 29506-2537 | 2006-04-13 |
| 1083695621 | Mcleod Regional Medical Center of The Pee Dee, Inc | General Acute Care Hospital | 701 Cashua Ferry Rd, Darlington, SC 29532-8488 | 2005-11-10 |
| Street Address |
555 E CHEVES ST |
| City | FLORENCE |
| State | SC |
| Zip Code | 29506-2617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689670135 | Andre T. Creese | Emergency Medicine | 555 E Cheves St, Florence, SC 29506-2617 | 2005-06-21 |
| 1669070694 | Meghan Joan Wallace | Nurse Practitioner | 555 E Cheves St, Florence, SC 29506-2617 | 2020-10-12 |
| 1437776267 | Nicole Mckenzie Preder | Dietitian, Registered | 555 E Cheves St, Florence, SC 29506-2617 | 2020-06-27 |
| 1326661000 | Christopher Bradley Tyner | Nurse Anesthetist, Certified Registered | 555 E Cheves St, Florence, SC 29506-2617 | 2020-05-28 |
| 1588285480 | Kenya Evette Thomas | Student in an Organized Health Care Education/Training Program | 555 E Cheves St, Florence, SC 29506-2617 | 2020-05-01 |
| 1437788056 | Deleisha Mcfadden | Nurse Anesthetist, Certified Registered | 555 E Cheves St, Florence, SC 29506-2617 | 2020-04-06 |
| 1902435084 | Charlee Caroline Pittman | Family Medicine | 555 E Cheves St, Florence, SC 29506-2617 | 2020-04-02 |
| 1194353250 | Michael Craig Corso | Family Medicine | 555 E Cheves St, Florence, SC 29506-2617 | 2020-04-01 |
| 1164050373 | Michael Shea | Family Medicine | 555 E Cheves St, Florence, SC 29506-2617 | 2020-04-01 |
| 1184252926 | Lauren Veronica Benning | Family Medicine | 555 E Cheves St, Florence, SC 29506-2617 | 2020-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871001693 | Med Way Ambulance Service, LLC | Ambulance | 1627 E Palmetto St, Florence, SC 29506 | 2018-01-15 |
| 1851810261 | Daijavon Jaquita Mccall | Specialist/Technologist | 1207 Malloy Street, Florence, SC 29506 | 2017-09-18 |
| 1629453873 | Rebecca Diboni | Pharmacist | 501 E Cheves St, Suite D, Florence, SC 29506 | 2015-07-29 |
| 1710365846 | Tiffany Joann Williams | Counselor | 205 Pearl Cir Florence, Sc, SC 29506 | 2015-05-08 |
| 1275925091 | Joe Brice Williamson Jr. | Pharmacist | 501 E. Cheves St., Suite D, Florence, SC 29506 | 2015-03-03 |
| 1528474632 | La'keisha Coker | Dietitian, Registered | 145 E. Cheves St., Florence County Health Department, Florence, SC 29506 | 2014-07-09 |
| 1275948085 | Patrick Kevin Mccarthy | Dietitian, Registered | 145 East Cheves Street, Florence County Health Dept., Florence, SC 29506 | 2014-07-01 |
| 1073931655 | Gwen A Davis | Registered Nurse | 145 E Cheves Street, Sc Dhec Pee Dee Region, Florence, SC 29506 | 2014-04-01 |
| 1205267879 | Jessica Turner | Physical Therapist | 555 E Cheves St., Inpatient Rehab Department, Florence, SC 29506 | 2013-12-09 |
| 1700213923 | Pamela Orange | Nurse's Aide | 2501 Sparklberry Lane, Florence, SC 29506 | 2013-10-02 |
| Find all providers in zip 29506 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396937934 | Jeremy Ray Robertson | Emergency Medicine | 555 E Cheves St, Florence, SC 29506-2617 | 2007-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164999744 | Joseph Simmons Jr. | Emergency Medicine | 3300 W Brewington Rd, Sumter, SC 29153-8336 | 2018-10-31 |
| 1053720417 | Ralph Mckeetha Shealy | Emergency Medicine | 2719 Coddell Ct, Mount Pleasant, SC 29466-7930 | 2014-08-10 |
| 1508158296 | Toni Nmi Manos | Emergency Medicine | 1742 E. Ashley Ave., Folly Beach, SC 29439-0049 | 2011-05-12 |
| 1104096619 | Steve W. Schwartz | Emergency Medicine | 671 Jamestown Dr Ste 203, Murrells Inlet, SC 29576-7507 | 2008-03-11 |
| 1629294798 | Clara Elisabeth Gulyas | Emergency Medicine | 202 Wall St, Piedmont, SC 29673-6754 | 2007-04-17 |
| 1598897951 | Stephen A Harvey | Emergency Medicine | 3655 Mitchell St # 690001, Loris, SC 29569-2827 | 2007-03-12 |
| 1285776674 | Cox Medical Response Inc | Emergency Medicine | 312 S Pine St, Marion, SC 29571 | 2007-02-13 |
| 1285706747 | Malcolm Keith Sale | Emergency Medicine | 20 Balmoral Pl, Hilton Head Island, SC 29926-2270 | 2006-11-13 |
| 1629169867 | James D Dunda | Emergency Medicine | 1011 Ella St, Anderson, SC 29621-4807 | 2006-09-27 |
| 1518068873 | Marva Denise Williams | Emergency Medicine | 107 Sunset Dr, Manning, SC 29102-2904 | 2006-09-26 |
| Find all providers with the same taxonomy | ||||
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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.