MCLEOD HEALTH CLARENDON (NPI# 1497104525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497104525 |
| Entity Type | Organization |
| Organization Name | MCLEOD HEALTH CLARENDON |
| Other Organization Name | MCLEOD FAMILY MEDICINE-PALMETTO |
| Practice Address |
22 Bozard St Manning SC 29102-2935 |
| Practice Telephone | 8034358828 |
| Mailing Telephone | 8034358828 |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2019-02-25 |
| Authorized Official Name | MR. SAMUEL FULTON ERVIN III (SR VICE PRESIDENT AND CFO) |
| Authorized Official Telephone | 8437772910 |
| Is Organization Subpart | Y |
| Parent Organization Name | MCLEOD HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | MEDICARE | 42-3460 | 01 |
| SC | RHC243 | 05 |
| Other Name | Type Code |
|---|---|
| McLeod Family Medicine-Palmetto | Doing Business As Name - Organization |
| McLeod Primary Care Clarendon | 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 |
| 1144875774 | Mcleod Health Clarendon | Family Medicine | 355 S Georgetown Hwy, Johnsonville, SC 29555-8083 | 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 |
| 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 |
22 BOZARD ST |
| City | MANNING |
| State | SC |
| Zip Code | 29102-2935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730166430 | Lisa E Heichberger | Family Medicine | 22 Bozard St, Manning, SC 29102-2935 | 2005-12-23 |
| 1083067714 | Mcleod Physician Associates II | Internal Medicine | 22 Bozard St, Manning, SC 29102-2935 | 2016-07-18 |
| 1104243518 | Amber Nicole Ballentine | Nurse Practitioner | 22 Bozard St, Manning, SC 29102-2935 | 2014-03-24 |
| 1205069770 | Susanne P Johnson | Nurse Practitioner | 22 Bozard St, Manning, SC 29102-2935 | 2009-08-31 |
| 1932303708 | Anne Christina Zimmerman | Family Medicine | 22 Bozard St, Manning, SC 29102 | 2007-06-13 |
| 1366521874 | Clarendon Memorial Hospital | Clinic/Center | 22 Bozard St, Manning, SC 29102-2935 | 2006-11-03 |
| 1780658195 | Mcleod Physician Associates, Inc. | Family Medicine | 22 Bozard St, Manning, SC 29102-2935 | 2006-02-14 |
| 1598738593 | Clarence E Coker Jr. | Family Medicine | 22 Bozard St, Manning, SC 29102-2935 | 2006-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720546138 | Dental Wellness Center of Manning, LLC | Clinic/Center | 1988 Paxille Hwy, Ste 613-01, Manning, SC 29102 | 2019-03-05 |
| 1982148433 | Allison Elaine Saran | Registered Nurse | Mcleod Women's Health, 50 East Hospital Street Suite 4a, Manning, SC 29102 | 2016-12-16 |
| 1629529698 | Clarendon Behavioral Health | Health Maintenance Organization | 14 N. Church Street, Manning, SC 29102 | 2016-10-14 |
| 1396158200 | Monica Ploetzke | Obstetrics & Gynecology | 50 E Hospital St Ste 4a, Manning, SC 29102 | 2014-06-09 |
| 1336567239 | Marian Moody | Registered Nurse | 110 Boyce Street, Dhec Clarendon County Health Dept, Manning, SC 29102 | 2014-03-29 |
| 1700212420 | Southern Lakes Therapy,llc | Physical Therapist | 297 W Boyce St, Manning, SC 29102 | 2013-09-26 |
| 1902190473 | Professional Care of Manning, LLC | In Home Supportive Care | 220 West Boyce St, Manning, SC 29102 | 2011-06-02 |
| 1275789810 | Vital Care Ambulance Service, LLC. | Ambulance | 3662 Greeleyville Hwy, Manning, SC 29102 | 2008-08-14 |
| 1831384015 | Ramona J Howard | Registered Nurse | 10 E. Hospital Street, Hospitalist Department, Manning, SC 29102 | 2007-09-11 |
| 1619098670 | H P Bozard Dds Pa | Dentist | 17 East Hospital Street, Manning, SC 29102 | 2007-04-03 |
| Find all providers in zip 29102 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356458061 | William C. Aldrich | Family Medicine | 1036 Professional Ct, Manning, SC 29102-2827 | 2006-08-25 |
| 1538188495 | Clarendon Memorial Hospital | Family Medicine | 22 Bozard Street, Manning, SC 29102 | 2006-07-19 |
| 1326089590 | Clarendon Memorial Hospital | Family Medicine | 50 Hospital St, Suite 4, Manning, SC 29102 | 2006-06-09 |
| 1003878455 | Edward C. Keith Jr. | Family Medicine | 15 E Hospital St, Manning, SC 29102-3152 | 2006-04-03 |
| 1730166430 | Lisa E Heichberger | Family Medicine | 22 Bozard St, Manning, SC 29102-2935 | 2005-12-23 |
| 1659367241 | Manning Family Healthcare Clinic PC | Family Medicine | 321 Center St, Manning, IA 51455-1020 | 2005-09-20 |
| 1710973391 | Philip L Myer | Family Medicine | 1550 6th Street, Manning, IA 51455-1004 | 2005-09-20 |
| 1558366039 | Robert S Eagerton Jr. | Family Medicine | 200 E Hospital St, Manning, SC 29102-3160 | 2005-06-20 |
| 1790247252 | Ohio Valley Physicians Inc | Family Medicine | 14 N Church St, Manning, SC 29102-3502 | 2019-04-03 |
| 1689194060 | Clarendon Health and Wellness Center | Family Medicine | 107 Sunset Dr, Manning, SC 29102-2904 | 2017-06-26 |
| Find all providers in MANNING | ||||
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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.