MARY BLACK HEALTH SYSTEM, LLC


Address: 147 Oakwood Ave, Spartanburg, SC 29302-1207
Phone: 8645828135

MARY BLACK HEALTH SYSTEM, LLC (NPI# 1588679922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1588679922
Entity Type Organization
Organization Name MARY BLACK HEALTH SYSTEM, LLC
Other Organization Name PEDIATRIC ASSOCIATES
Practice Address 147 Oakwood Ave
Spartanburg
SC 29302-1207
Mailing Address 138 Dillon Dr Ste A
Spartanburg
SC 29307-1018
Practice Telephone 8645828135
Mailing Telephone 8645428980
Mailing Fax Number 8645159994
Enumeration Date 2006-07-31
Last Update Date 2007-08-14
Authorized Official Name DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
Authorized Official Telephone 6154657000
Is Organization Subpart Y
Parent Organization Name MARY BLACK HEALTH SYSTEM, LLC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 332B00000X Durable Medical Equipment & Medical Supplies Suppliers
Y 208000000X Pediatrics Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
SC GP2480 05

Other Provider/Organization Names

Other Name Type Code
Pediatric Associates Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1518074194 Mary Black Health System, LLC Obstetrics & Gynecology 1686 Skylyn Dr Ste 101, Spartanburg, SC 29307-1058 2006-08-23
1629087754 Mary Black Health System, LLC Durable Medical Equipment & Medical Supplies 2995 Reidville Rd Ste 260, Spartanburg, SC 29301-5667 2006-08-07
1679582712 Mary Black Health System, LLC Obstetrics & Gynecology 2995 Reidville Rd Ste 290, Spartanburg, SC 29301-5667 2006-08-07
1710995105 Mary Black Health System, LLC Obstetrics & Gynecology 123 Dillon Dr, Spartanburg, SC 29307-1017 2006-08-03
1376551713 Mary Black Health System, LLC Urology 1 Doctors Park Dr, Spartanburg, SC 29307-1021 2006-08-03
1932117389 Mary Black Health System, LLC Durable Medical Equipment & Medical Supplies 245 E Blackstock Rd, Spartanburg, SC 29301-2633 2006-08-03
1871500843 Mary Black Health System, LLC Durable Medical Equipment & Medical Supplies 145b Dillon Dr, Spartanburg, SC 29307-1017 2006-08-02
1073529699 Mary Black Health System, LLC Durable Medical Equipment & Medical Supplies 1605 Drayton Ave, Spartanburg, SC 29305 2006-08-01
1528075082 Mary Black Health System, LLC Durable Medical Equipment & Medical Supplies 138 Dillon Dr Ste A, Spartanburg, SC 29307-1018 2006-08-01
1922013721 Mary Black Health System, LLC Durable Medical Equipment & Medical Supplies 2212 Old Furnace Rd, Boiling Springs, SC 29316-5782 2006-07-30

Office Location

Street Address 147 OAKWOOD AVE
City SPARTANBURG
State SC
Zip Code 29302-1207

Providers in the same location

NPI Name Taxonomy Address Enumeration
1619920808 H Heywood Nettles Pediatrics 147 Oakwood Ave, Spartanburg, SC 29302-1207 2006-05-18

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1083226476 Healthstat Inc Grace Management Preventive Medicine 951 South Pin Street, Suite 200, Spartanburg, SC 29302 2020-08-18
1467978304 Katherine Tomes Speech-Language Pathologist 355 Cedar Springs Road, Spartanburg, SC 29302 2017-08-22
1396291167 Brent Timothy Smith Specialist 151 Ribault Street Suite 200, Spartanburg, SC 29302 2016-08-31
1376995159 Natalie Nicole Kellett Nurse Practitioner 120 Heywood Avenue Suite 200, Spartanburg, SC 29302 2016-07-06
1902273808 Tamieka Latrell Alston-gibson Nurse Practitioner 101 North Pine Street, Suite 210, Spartanburg, SC 29302 2015-08-26
1700209905 Robert W Wyatt Pharmacist 203 Cedar Springs Rd, Spartanburg, SC 29302 2014-01-24
1952735748 James Sidney Fulmer Sr. Obstetrics & Gynecology 167 Ivy Court, Spartanburg, SC 29302 2013-08-28
1053651828 Jennifer Geddes Hall Counselor 101 N Pine St Ste 210, Spartanburg, SC 29302 2013-02-15
1487875514 Park Place Spartanburg Assisted Living Facility 2720 Country Clud Road, Spartanburg, SC 29302 2007-05-02
1740304401 Leon Derek Herring Dentist 270 Cedar Spring Rd, Spartanburg, SC 29302 2007-03-19
Find all providers in zip 29302

Taxonomy Information

Taxonomy Code 208000000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics

Taxonomy Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1275900961 Gateway Children's Pediatrics 397 Serpentine Dr, Ste B, Spartanburg, SC 29303-3067 2015-08-28
1447477344 Ann Marie Harrill Edwards Pediatrics 249 North Grove Medical Park Dr, Ste 100, Spartanburg, SC 29603-4222 2007-04-20
1245393776 Monique Hope Fox Pediatrics 750 South Church Street, Spartanburg, SC 29306 2006-12-18
1083795934 Christine Hidalgo Philpott Pediatrics 201 E Broad St, Spartanburg, SC 29306-3233 2006-10-18
1801837968 William Travis Weathers Pediatrics 1650 Skyn Drive, Suite 240, Spartanburg, SC 29307-1069 2006-06-09
1093769804 George Chester Glenn IIi Pediatrics 1686 Skyland Drive, Suite 201, Spartanburg, SC 29307 2006-05-19
1386697175 Michelle Lynn Prigge Pediatrics 249 N Grove Medical Park Dr Ste 100, Spartanburg, SC 29303 2006-05-19
1619920808 H Heywood Nettles Pediatrics 147 Oakwood Ave, Spartanburg, SC 29302-1207 2006-05-18
1871552315 Steven Douglas Egge Sr. Pediatrics 3020 Reidville Rd Ste B, Spartanburg, SC 29301-5641 2006-03-22
1891765533 Shelley Mahaffey Pediatrics 8311 Warren H Abernathy Hwy, Spartanburg, SC 29301-1249 2006-01-25
Find all providers in SPARTANBURG

Competitor

Search similar providers

City SPARTANBURG
Zip Code 29302

Improve Information

Please comment or provide details below to improve the information on MARY BLACK HEALTH SYSTEM, LLC.

Dataset Information

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.

Trending Searches