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Mcleod Physician Associates II

Family Medicine Physician in Latta, SC · enumerated 2007 · authorized official Paul Provenzano, Regional Practice Manager/Avp.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1689869018

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Registry record

Entity type Organization (Type 2)
Legal business name Mcleod Physician Associates II
Other name <Unavail>
Parent organization Mcleod Health
Practice address 108a East Main Street, Latta, SC, 29565
Phone (843) 752-5111
Fax (843) 752-5100
Enumeration date Sep 10, 2007
Last updated in NPPES Mar 27, 2009

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Primary
261QR1300X Rural Health Clinic/Center Ambulatory Health Care Facilities Secondary
363LF0000X Family Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Secondary

Authorized official

Name Paul Provenzano
Title Regional Practice Manager/Avp
Phone (843) 777-7030

Other identifiers

Identifier Type State Issuer
GP4874 Medicaid SC -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Mcleod Physician Associates II?
The NPI for Mcleod Physician Associates II is 1689869018, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Mcleod Physician Associates II?
NPPES lists Paul Provenzano (Regional Practice Manager/Avp) as the authorized official for this organization.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2009-03-27.