MCLEOD FAMILY MEDICINE KINGSTREE
NPI 1275689002
Clinic/Center - Rural Health in Kingstree, SC

Active since January 26, 2007CLIA 42D0019897 · Waiver
512 NELSON BLVD STE 200, KINGSTREE, SC 29556(843) 355-5459(843) 355-9704 Get Directions Write a Review

NPPES record last updated: August 8, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 8, 2019, May 21, 2019 (2 updates tracked since 2019).

About Mcleod Family Medicine Kingstree NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MCLEOD FAMILY MEDICINE KINGSTREE (NPI 1275689002) is a healthcare organization registered as a rural health in Kingstree, South Carolina and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through September 27, 2027 and lists Samuel Fulton Ervin, Sr Vice President And Cfo, as its authorized official.

NPPES Registry Identity

NPI1275689002
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameMCLEOD PHYSICIAN ASSOCIATES II
Location Address512 NELSON BLVD STE 200Kingstree, SC 29556-4027
Mailing AddressPo Box 3239Florence, SC 29502-3239 · (843) 777-7162 · Fax (843) 777-7102
Fax(843) 355-9704
Organization SubpartYesParent: Mcleod Health
Authorized OfficialSamuel Fulton ErvinSr Vice President And Cfo · (843) 777-2910
Enumeration DateJanuary 26, 2007
Last NPPES UpdateAugust 8, 20192 updates tracked since enumeration
NPI 1275689002 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
License Licensed in SC · 11529
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X
512 NELSON BLVD STE 200, Kingstree, SC 29556

Other Names 1

Doing Business AsMcleod Family Medicine Kingstree

Other Identifiers 1

MedicaidRHC047SC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 42D0019897

Mcleod Family Medicine Kingstree · Kingstree, SC
Active · expires Sep 27, 2027
CLIA Number42D0019897
Laboratory TypePhysician Office
Certificate Effective DateSeptember 28, 2025
Certificate Expiration DateSeptember 27, 2027
Laboratory DirectorTroy B. Gamble Jr
Laboratory Phone(843) 355-5459
Laboratory LocationMcleod Family Medicine Kingstree665 Nelson Blvd, Kingstree, SC 29556
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
512 NELSON BLVD STE 200
KINGSTREE, SC 29556
Physician Assistant (Medical)
512 NELSON BLVD STE 200
KINGSTREE, SC 29556
Family Medicine
512 NELSON BLVD STE 200
KINGSTREE, SC 29556

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mcleod Physician Associates II's NPI number?

The NPI number for Mcleod Physician Associates II is 1275689002. It was assigned to this organization in the NPPES registry on January 26, 2007. The provider is doing business as Mcleod Family Medicine Kingstree.

Where is Mcleod Physician Associates II located?

Mcleod Physician Associates II is located at 512 Nelson Blvd Ste 200, Kingstree, SC 29556. The listed phone number is (843) 355-5459.

What is Mcleod Physician Associates II's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Mcleod Physician Associates II hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D0019897) is associated with this NPI, valid through September 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mcleod Physician Associates II was last updated on August 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.