MARY BLACK HEALTH SYSTEM, LLC (NPI# 1679582712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679582712 |
| Entity Type | Organization |
| Organization Name | MARY BLACK HEALTH SYSTEM, LLC |
| Other Organization Name | CAROLINA OB/GYN |
| Practice Address |
2995 Reidville Rd Ste 290 Spartanburg SC 29301-5667 |
| Mailing Address |
138 Dillon Dr Ste A Spartanburg SC 29307-1018 |
| Practice Telephone | 8645744483 |
| Mailing Telephone | 8645428980 |
| Mailing Fax Number | 8645159994 |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2008-06-19 |
| Authorized Official Name | REBECCA HURLEY (SR VP) |
| Authorized Official Telephone | 2144733993 |
| Is Organization Subpart | Y |
| Parent Organization Name | MARY BLACK HEALTH SYSTEM, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
| N | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
Allopathic & Osteopathic Physicians | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP1599 | 05 |
| Other Name | Type Code |
|---|---|
| Carolina OB/GYN | Doing Business As Name - Organization |
| 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 |
| 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 |
| 1770506990 | Mary Black Health System, LLC | Family Medicine | 130 Dillon Dr, Spartanburg, SC 29307-1018 | 2006-07-26 |
| Street Address |
2995 REIDVILLE RD STE 290 |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29301-5667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033716253 | Proactive Md Tindall Spartanburg Health Center | Family Medicine | 2273 Hayne St., Spartanburg, SC 29301 | 2020-10-01 |
| 1841757192 | Paladina Health, LLC | Family Medicine | Paladina Health Smith Drug, 9098 Fairforest Road, Spartanburg, SC 29301 | 2019-02-22 |
| 1073021143 | Yamira Valentin-fuentes | Chiropractor | 210 Westgate Mall Dr, Suite 6, Spartanburg, SC 29301 | 2018-01-11 |
| 1124426382 | Shellie Smith | Social Worker | 101 Washington Place, Spartanburg, SC 29301 | 2014-12-19 |
| 1356751770 | Lindsey Marie Dillon | Counselor | 250 Dewey Ave., Spartanburg, SC 29301 | 2014-05-07 |
| 1568892461 | Lauren Campbell Heiser | Physical Therapist | 2660 Reidville Rd # 6&7, Spartanburg, SC 29301 | 2013-11-14 |
| 1871843227 | Amy L Roberts | Occupational Therapist | 355 Oak Grove Rd., Spartanburg, SC 29301 | 2012-09-13 |
| 1023384419 | Elizabeth B. Gurley | Pharmacist | 211 West Blackstock Rd, Spartanburg, SC 29301 | 2012-03-29 |
| 1649564063 | Brooke Webster Fuentes | Physician Assistant | 300 E Blackstock Road, Suite E, Spartanburg, SC 29301 | 2011-06-02 |
| 1487943023 | Margaret Elizabeth Wilson | Counselor | 100 Ezell St., Spartanburg, SC 29301 | 2011-04-05 |
| Find all providers in zip 29301 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952735748 | James Sidney Fulmer Sr. | Obstetrics & Gynecology | 167 Ivy Court, Spartanburg, SC 29302 | 2013-08-28 |
| 1518306059 | Misty L Mcdowell | Obstetrics & Gynecology | 853 N Church St Ste 610, Spartanburg, SC 29303-3070 | 2013-06-18 |
| 1437248259 | Christy Grant Kobes | Obstetrics & Gynecology | 211 Indian Wells Dr, Spartanburg, SC 29306-6669 | 2006-10-12 |
| 1710995105 | Mary Black Health System, LLC | Obstetrics & Gynecology | 123 Dillon Dr, Spartanburg, SC 29307-1017 | 2006-08-03 |
| 1043251291 | Kristine Dee Boyd | Obstetrics & Gynecology | 853 N Church St Ste 700, Spartanburg, SC 29303 | 2006-06-09 |
| 1699729459 | Aaron M Toler | Obstetrics & Gynecology | 1686 Skylyn Drive, Suite 101, Spartanburg, SC 29307 | 2006-05-19 |
| 1598722290 | Mary Haddad | Obstetrics & Gynecology | 250 North Grove Medical Park Dr, Spartanburg, SC 29303-4222 | 2006-04-27 |
| 1285696690 | Peter Arnold Sereque | Obstetrics & Gynecology | 250 N Grove Medical Park Dr, Spartanburg, SC 29303-4222 | 2006-04-03 |
| 1861475402 | Emory Levon Eastin | Obstetrics & Gynecology | 1686 Skylyn Dr, Suite 101, Spartanburg, SC 29307-1058 | 2005-11-29 |
| 1245700301 | Spartanburg Medical Center | Obstetrics & Gynecology | 1686 Skylyn Dr Ste 201, Spartanburg, SC 29307-1079 | 2018-12-03 |
| Find all providers in SPARTANBURG | ||||
| City | SPARTANBURG |
| Zip Code | 29301 |
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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.