MARY BLACK HEALTH SYSTEM LLC (NPI# 1861415085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861415085 |
| Entity Type | Organization |
| Organization Name | MARY BLACK HEALTH SYSTEM LLC |
| Other Organization Name | SQUIRES POINTE MEDICAL PARK |
| Practice Address |
500 Squires Pointe Duncan SC 29334 |
| Mailing Address |
Po Box 406757 Atlanta GA 30384-6757 |
| Practice Telephone | 8644338980 |
| Mailing Telephone | 8642538080 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2008-06-25 |
| 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 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP2924 | 05 |
| Other Name | Type Code |
|---|---|
| Squires Pointe Medical Park | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619162229 | Mary Black Health System LLC | Durable Medical Equipment & Medical Supplies | 138 Dillon Dr, Spartanburg, SC 29307-1018 | 2007-09-07 |
| 1811030760 | Mary Black Health System LLC | Family Medicine | 1686 Skylyn Dr Ste 201, Spartanburg, SC 29307-1058 | 2007-02-14 |
| 1699839530 | Mary Black Health System LLC | Orthopaedic Surgery | 724 Hyatt St, Suite F, Gaffney, SC 29341-2630 | 2006-12-21 |
| 1609983287 | Mary Black Health System LLC | Durable Medical Equipment & Medical Supplies | 724 Hyatt St Ste 2-d, Gaffney, SC 29341-2630 | 2006-08-23 |
| 1073620654 | Mary Black Health System LLC | Obstetrics & Gynecology | 1686 Skylyn Dr Ste 102, Spartanburg, SC 29307-1058 | 2006-08-23 |
| 1962519546 | Mary Black Health System LLC | Surgery | 1690 Skylyn Dr Ste 350, Spartanburg, SC 29307-1039 | 2006-08-23 |
| 1801900865 | Mary Black Health System LLC | Family Medicine | 724 Hyatt St Ste D, Gaffney, SC 29341-2630 | 2006-08-18 |
| 1326061540 | Mary Black Health System LLC | Family Medicine | 5470 N Main St, Cowpens, SC 29330-9705 | 2006-07-26 |
| 1720001076 | Mary Black Health System LLC | Family Medicine | 702 S Alabama Street, Chesnee, SC 29306 | 2006-07-26 |
| 1992990501 | Mary Black Health System LLC | Durable Medical Equipment & Medical Supplies | 724 Hyatt St, Suite D, Gaffney, SC 29341-2630 | 2007-09-07 |
| Street Address |
500 SQUIRES POINTE |
| City | DUNCAN |
| State | SC |
| Zip Code | 29334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487032272 | Polly Wright Rector | Specialist | 120 S Spencer St, Duncan, SC 29334 | 2015-05-12 |
| 1417343286 | Rubina Batool Baksh | Pediatrics | 500 Squires Pt Ste A, Duncan, SC 29334 | 2015-04-08 |
| 1922274463 | Joseph Brandon Chadwell | Dentist | 705 Squires Pt, Duncan, SC 29334 | 2008-05-05 |
| 1306068127 | Worth Family Chiropractic | Chiropractor | 1531 E Main St #2, Duncan, SC 29334 | 2007-05-02 |
| 1912031717 | Laura Ann Gray | Speech-Language Pathologist | 407 Caperton Way, Duncan, SC 29334 | 2007-03-15 |
| 1457429078 | Spartanburg County School District No. 5 | Registered Nurse | 100 N. Danzler Rd, Duncan, SC 29334 | 2006-12-01 |
| 1003913328 | World Class Healthcare Pa | Chiropractor | 700 Squire's Pt, Ste. B, Duncan, SC 29334 | 2006-09-20 |
| 1245348242 | Craig Bernard Pruitt | Optometrist | Vision Plus 1955 E Main St, 1955 East Main St. Suite C., Duncan, SC 29334 | 2006-08-29 |
| 1982622585 | Derek T Dunlap | Dentist | 700 Squire's Pointe Drive, Suite A, Duncan, SC 29334 | 2006-07-18 |
| 1306872080 | Edward J Mea | Family Medicine | 500 Squires Pt, Duncan, SC 29334 | 2006-06-24 |
| Find all providers in zip 29334 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104009299 | Solutions Practice Management | Family Medicine | 2210 Duncan Regional Loop Rd, Duncan, OK 73533-1564 | 2007-12-11 |
| 1982773685 | Sallie Jane Waters | Family Medicine | 1313 Jackie Rd., Duncan, OK 73533 | 2006-11-07 |
| 1902837826 | Paul W Kliewer | Family Medicine | 227 Main St., Duncan, AZ 85534 | 2006-07-06 |
| 1962433748 | Charles Wayne Dickerson | Family Medicine | 1601 Brookwood Ave, Duncan, OK 73533-1360 | 2006-07-06 |
| 1306872080 | Edward J Mea | Family Medicine | 500 Squires Pt, Duncan, SC 29334 | 2006-06-24 |
| 1881639466 | Douglas Wayne Whitehead | Family Medicine | 245 Parkway E, Duncan, SC 29334-9489 | 2006-06-18 |
| 1891733994 | Spartanburg Medical Center | Family Medicine | 1575 E Main Street, Duncan, SC 29334-9218 | 2006-06-02 |
| 1407823982 | Judith Marie Gilbreth | Family Medicine | 1330 N Harville Rd, Duncan, OK 73533-1514 | 2006-03-03 |
| 1568432102 | Richard Lucarelli | Family Medicine | 1575 E Main St, Duncan, SC 29334-9218 | 2006-01-25 |
| 1942289939 | Cynthia Ann Norman | Family Medicine | 1315 Jackie Rd, Duncan, OK 73533-1566 | 2006-01-10 |
| Find all providers in DUNCAN | ||||
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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.