MCLEOD PHYSICIAN ASSOCIATES II (NPI# 1730413949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730413949 |
| Entity Type | Organization |
| Organization Name | MCLEOD PHYSICIAN ASSOCIATES II |
| Other Organization Name | MCLEOD VASCULAR ASSOCIATES |
| Practice Address |
101 S Ravenel St Suite 230 Florence SC 29506-2644 |
| Mailing Address |
Po Box 3239 Florence SC 29502-3239 |
| Practice Telephone | 8437777043 |
| Practice Fax Number | 8437777041 |
| Mailing Telephone | 8437777043 |
| Mailing Fax Number | 8437777041 |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2015-02-26 |
| Authorized Official Name | DANE P. FICCO (SENIOR VICE PRESIDENT) |
| Authorized Official Telephone | 8437777000 |
| Is Organization Subpart | Y |
| Parent Organization Name | MCLEOD HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
SC | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | TRICARE | 029 | 01 |
| SC | BCBS | 067 | 01 |
| Other Name | Type Code |
|---|---|
| McLeod Vascular Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750999405 | Mcleod Physician Associates II | Family Medicine | 4237 River Hills Dr Ste 170, Little River, SC 29566-6446 | 2020-07-20 |
| 1831717693 | Mcleod Physician Associates II | Surgery | 690 Sunset Blvd N Ste 208, Sunset Beach, NC 28468-5332 | 2020-07-08 |
| 1588280747 | Mcleod Physician Associates II | Nurse Practitioner | 1126 Clarence Coker Hwy., Turbeville, SC 29162-8983 | 2020-06-23 |
| 1457977852 | Mcleod Physician Associates II | Internal Medicine | 800 E Cheves St Ste 400, Florence, SC 29506-2649 | 2020-06-22 |
| 1326672361 | Mcleod Physician Associates II | Family Medicine | 800 E Cheves St Ste 240, Florence, SC 29506-2652 | 2020-02-28 |
| 1003321167 | Mcleod Physician Associates II | Internal Medicine | 1319 South 4th Street, Hartsville, SC 29550 | 2017-12-11 |
| 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 |
| 1801326814 | Mcleod Physician Associates II | Dermatology | 401 E Cheves St Ste 302, Florence, SC 29506-2615 | 2017-06-13 |
| 1407393861 | Mcleod Physician Associates II | Radiology | 1116 W Evans St, Florence, SC 29501-3320 | 2017-01-24 |
| Street Address |
101 S RAVENEL ST SUITE 230 |
| City | FLORENCE |
| State | SC |
| Zip Code | 29506-2644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801890298 | Kenneth Stuart Kammer | Specialist | 101 S Ravenel St, Ste 300, Florence, SC 29506-2612 | 2005-06-13 |
| 1356725386 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 101 S Ravenel St, Florence, SC 29506-2618 | 2015-07-20 |
| 1912392127 | Mcleod Physician Associates II | Internal Medicine | 101 S Ravenel St, Suite 300, Florence, SC 29506-2618 | 2015-04-03 |
| 1437541901 | Mcleod Physician Associates II | Internal Medicine | 101 S Ravenel St, Suite 120, Florence, SC 29506-2618 | 2015-02-20 |
| 1073826624 | Carmen Michael Piccolo IIi | Surgery | 101 S Ravenel St, Suite 230, Florence, SC 29506-2618 | 2010-07-23 |
| 1184943508 | Mcleod Physician Associates II | Internal Medicine | 101 S Ravenel St, Suite 220, Florence, SC 29506-2618 | 2010-05-25 |
| 1184880049 | Mhd Adnan Alsaka | Internal Medicine | 101 S Ravenel St, Suite 120, Florence, SC 29506-2618 | 2008-07-31 |
| 1710010665 | Yarrow L Babb | Physician Assistant | 101 S Ravenel St, Suite 270, Florence, SC 29506-2644 | 2007-03-13 |
| 1114083680 | Ashley Tumlin Moody | Physician Assistant | 101 S Ravenel St, Suite 230, Florence, SC 29506-2618 | 2006-12-29 |
| 1699881110 | Bernice Floella Shupe | Nurse Practitioner | 101 S Ravenel St, Suite 230, Florence, SC 29506-2644 | 2006-08-21 |
| 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 | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104237338 | William Jackson | Surgery | 101 S Ravenel St Ste 230, Florence, SC 29506-2624 | 2014-05-09 |
| 1184976789 | Mcleod Physician Associates II | Surgery | 901 E Cheves St, Suite 430, Florence, SC 29506-2716 | 2012-10-05 |
| 1285900597 | Brian Paul Fletcher | Surgery | 2129 Helton Dr, Florence, AL 35630 | 2012-03-30 |
| 1073826624 | Carmen Michael Piccolo IIi | Surgery | 101 S Ravenel St, Suite 230, Florence, SC 29506-2618 | 2010-07-23 |
| 1699787523 | Eva Maria Rzucidlo | Surgery | 101 S Ravenel St, Suite 230, Florence, SC 29506-2618 | 2006-08-12 |
| 1619994233 | Mcleod Physician Associates II | Surgery | 800 E Cheves St, Ste 260, Florence, SC 29506-2652 | 2006-07-17 |
| 1932155306 | The Health Care Authority of Lauderdale County & The City of Florence | Surgery | 541 W College St, Suite 2000, Florence, AL 35630-5323 | 2006-05-26 |
| 1104899145 | Mcleod Physician Associates II | Surgery | 101 South Ravenel Street, Suite 270, Florence, SC 29506-2610 | 2006-02-09 |
| 1205814019 | Peter John Pons | Surgery | 541 W College St, Suite 2000, Florence, AL 35630-5323 | 2006-01-03 |
| 1558351122 | Christopher G Cunningham | Surgery | 101 S Ravenel St, Suite 230, Florence, SC 29506-2644 | 2005-10-25 |
| Find all providers in FLORENCE | ||||
Please comment or provide details below to improve the information on MCLEOD PHYSICIAN ASSOCIATES II.
| 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.