MCLEOD HEALTH CLARENDON NPI 1144875774

NPI Information

  • NPI: 1144875774
  • Provider Name: MCLEOD HEALTH CLARENDON
  • Classification: Clinic/Center - 261QR1300X
  • Specialization: Rural Health
  • Entity Type: Organization
  • Doing Business As: MCLEOD FAMILY MEDICINE-JOHNSONVILLE
  • CLIA Number: 42D0970936
  • Address: 355 S GEORGETOWN HWY
    JOHNSONVILLE, SC
    ZIP 29555
  • Phone: (843) 380-2000

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NPI Details

MCLEOD HEALTH CLARENDON is a rural health clinic center in Johnsonville, SC. MCLEOD HEALTH CLARENDON NPI is 1144875774. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mcleod Family Medicine-johnsonville.

The provider's business location address is:

355 S GEORGETOWN HWY
JOHNSONVILLE, SC
ZIP 29555-083
Phone: (843) 380-2000

The provider's authorized official is Samuel Fulton Ervin .
The authorized official title is Sr Vice President And Cfo and has the following contact phone number (843) 777-2910.

The CLIA number assigned to this NPI record is 42D0970936 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/9/2019 and was last updated on 8/14/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2363LF0000XNurse PractitionerFamilyNo
3261QR1300XClinic/CenterRural HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
142-8989OTHERSOUTH CAROLINAPTAN
2GP2568MEDICAIDSOUTH CAROLINA
3RHC176MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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