MARY BLACK PHYSICIANS GROUP LLC (NPI# 1336344852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336344852 |
| Entity Type | Organization |
| Organization Name | MARY BLACK PHYSICIANS GROUP LLC |
| Other Organization Name | MARY BLACK FAMILY MEDICINE DORMAN |
| Practice Address |
5229 Highway 221 Roebuck SC 29376-3305 |
| Practice Telephone | 8645768193 |
| Mailing Telephone | 8645768193 |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2008-08-08 |
| Authorized Official Name | DEBBIE T BREWER (DIRECTOR) |
| Authorized Official Telephone | 8778929813 |
| Is Organization Subpart | Y |
| Parent Organization Name | MARY BLACK PHYSICIANS GROUP LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Mary Black Family Medicine Dorman | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164667283 | Mary Black Physicians Group LLC | Durable Medical Equipment & Medical Supplies | 5229 Hwy 221, Roebuck, SC 29376-3305 | 2008-12-03 |
| 1427276203 | Mary Black Physicians Group LLC | Durable Medical Equipment & Medical Supplies | 170 Camelot Dr, Spartanburg, SC 29301-2650 | 2007-04-24 |
| 1235357260 | Mary Black Physicians Group LLC | Durable Medical Equipment & Medical Supplies | 145 Dillon Dr # B, Spartanburg, SC 29307-1017 | 2007-04-23 |
| 1619339660 | Mary Black Physicians Group LLC | Durable Medical Equipment & Medical Supplies | 2995 Reidville Rd, Spartanburg, SC 29301-5628 | 2016-03-28 |
| 1093171332 | Mary Black Physicians Group LLC | Durable Medical Equipment & Medical Supplies | 722 Hyatt St, Suite D, Gaffney, SC 29341-2643 | 2015-12-31 |
| 1053556191 | Mary Black Physicians Group LLC | Durable Medical Equipment & Medical Supplies | 2995 Reidville Rd, Spartanburg, SC 29301-5628 | 2008-12-03 |
| 1053511766 | Mary Black Physicians Group LLC | Durable Medical Equipment & Medical Supplies | 2995 Reidville Rd, Ste 290, Spartanburg, SC 29301-5628 | 2007-07-20 |
| 1669672358 | Mary Black Physicians Group LLC | Durable Medical Equipment & Medical Supplies | 5470 N Main St, Cowpens, SC 29330-9705 | 2007-07-20 |
| 1457555120 | Mary Black Physicians Group LLC | Clinic/Center | 108 W Rutherford St, Landrum, SC 29356-1526 | 2007-06-14 |
| 1518187228 | Mary Black Physicians Group LLC | Durable Medical Equipment & Medical Supplies | 500 Squires Pt, Suite B, Duncan, SC 29334-8867 | 2007-04-26 |
| Street Address |
5229 HIGHWAY 221 |
| City | ROEBUCK |
| State | SC |
| Zip Code | 29376-3305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740250877 | Christopher Lee Brown | Nurse Practitioner | 5229 Highway 221, Roebuck, SC 29376-3305 | 2006-01-23 |
| 1659840932 | Spartanburg Medical Center | Family Medicine | 5229 Highway 221, Roebuck, SC 29376-3305 | 2018-11-16 |
| 1740597178 | Divya Somaya Kulkarni | Family Medicine | 5229 Highway 221, Roebuck, SC 29376-3305 | 2010-09-07 |
| 1134364615 | Mary Black Physicians Group, LLC | Family Medicine | 5229 Highway 221, Roebuck, SC 29376-3305 | 2008-12-11 |
| 1801867577 | Carla F Gentry | Family Medicine | 5229 Highway 221, Roebuck, SC 29376-3305 | 2006-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629328992 | Cynthia Kaye Shinn | Pharmacist | 140 Jameson Drive, Roebuck, SC 29376 | 2012-09-14 |
| 1609100338 | Lisa Marie Fowler | Speech-Language Pathologist | 441 Lancaster Farm Rd, Alphabet Soup Therapy, Roebuck, NC 29376 | 2009-09-29 |
| 1710327374 | Jamie Duncan-chapman | Behavioral Analyst | 4301 S Church St, 1241, Roebuck, SC 29376-1241 | 2013-06-27 |
| 1427103761 | Spartan Health Services, Inc. | Durable Medical Equipment & Medical Supplies | 315 Carolina Drive Ext, Roebuck, SC 29376-2502 | 2007-01-25 |
| 1265414825 | David E. Byers | Durable Medical Equipment & Medical Supplies | 189 Becknell Dr, Roebuck, SC 29376-2600 | 2005-11-18 |
| 1043441678 | Freds Stores of Tennessee Inc | Durable Medical Equipment & Medical Supplies | 1876 E Blackstock Rd, Roebuck, SC 29376-2700 | 2009-07-30 |
| 1518360189 | Tara M Pinilla | Pharmacist | 1876 E Blackstock Rd, Roebuck, SC 29376-2700 | 2014-09-26 |
| 1538405758 | Rebecca Hendrix Finley | Pharmacist | 1876 E Blackstock Rd, Roebuck, SC 29376-2700 | 2012-12-15 |
| 1871880245 | Krishnan Patel | Pharmacist | 1876 E Blackstock Rd, Roebuck, SC 29376-2700 | 2011-07-06 |
| 1821146549 | Joseph Kayne Lever | Dentist | 2001 E Blackstock Rd, Suite 200, Roebuck, SC 29376-2734 | 2007-01-08 |
| Find all providers in zip 29376 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508482050 | The Palmetto Clinics, LLC | Clinic/Center | 463 Calhoun Ave Ste A-2, Greenwood, SC 29649-2063 | 2020-06-21 |
| 1962969154 | The Palmetto Palace | Clinic/Center | 217 Flat St E, Allendale, SC 29810-4647 | 2019-02-25 |
| 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 |
| 1154786960 | R Dale Padgett Md Pa | Clinic/Center | 1727 Villagepark Dr, Orangeburg, SC 29118 | 2015-12-21 |
| 1043602428 | Greenville Health System | Clinic/Center | 208 Frontage Rd Ste 1, Clemson, SC 29631-1671 | 2015-02-23 |
| 1114204153 | Mcleod Physician Associates II | Clinic/Center | 5260 Highway 9, Green Sea, SC 29545-4930 | 2011-11-04 |
| 1700160157 | Mackey Family Practice, Pa | Clinic/Center | 8351 Charlotte Hwy, Suite 200, Indian Land, SC 29707-6552 | 2011-10-04 |
| 1588943021 | Edisto Regional Health Services Inc. | Clinic/Center | 185 Mcgee St, Bamberg, SC 29003-1154 | 2011-08-16 |
| 1124307509 | Coastal Carolina Medical Center, Inc | Clinic/Center | 10911 N Jacob Smart Blvd, D, Ridgeland, SC 29936-2729 | 2011-08-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MARY BLACK PHYSICIANS GROUP LLC.
| 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.