MARY BLACK HEALTH SYSTEM LLC (NPI# 1992758296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992758296 |
| Entity Type | Organization |
| Organization Name | MARY BLACK HEALTH SYSTEM LLC |
| Other Organization Name | MARY BLACK HEALTH SYSTEM SPARTANBURG |
| Practice Address |
1700 Skylyn Dr Spartanburg SC 29307-1041 |
| Mailing Address |
1700 Skylyn Dr Po Box 3217 Spartanburg SC 29304 |
| Practice Telephone | 8645733000 |
| Practice Fax Number | 8645733277 |
| Mailing Telephone | 8645733000 |
| Mailing Fax Number | 8645733277 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2018-02-22 |
| Authorized Official Name | PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL) |
| Authorized Official Telephone | 6159254565 |
| Is Organization Subpart | Y |
| Parent Organization Name | MARY BLACK HEALTH SYSTEM LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | HTL-704 | SC | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 400836 | 05 | |
| SC | 382184 | 05 |
| Other Name | Type Code |
|---|---|
| Mary Black Health System Spartanburg | 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 |
| 1861415085 | Mary Black Health System LLC | Family Medicine | 500 Squires Pointe, Duncan, SC 29334 | 2006-07-26 |
| 1720001076 | Mary Black Health System LLC | Family Medicine | 702 S Alabama Street, Chesnee, SC 29306 | 2006-07-26 |
| Street Address |
1700 SKYLYN DR |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29307-1041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952395949 | Robert Neal Poteat | Specialist | 1700 Skylyn Dr, Spartanburg, SC 29307-1041 | 2005-09-06 |
| 1033681630 | Spartanburg Medical Center | Psychiatric Unit | 1700 Skylyn Dr, Spartanburg, SC 29307-1041 | 2018-12-20 |
| 1942772546 | Spartanburg Medical Center | Rehabilitation Unit | 1700 Skylyn Dr, Spartanburg, SC 29307-1041 | 2018-12-20 |
| 1659888246 | David Milton Rainville | Nurse Anesthetist, Certified Registered | 1700 Skylyn Dr, Spartanburg, SC 29307-1041 | 2018-01-04 |
| 1548779457 | John Nicholas Mann | Nurse Practitioner | 1700 Skylyn Dr, Spartanburg, SC 29307-1041 | 2017-09-22 |
| 1033633052 | Erin Shealy | Dietitian, Registered | 1700 Skylyn Dr, Spartanburg, SC 29307-1041 | 2017-08-01 |
| 1477098556 | Bethany Mckinney Wilson | Nurse Practitioner | 1700 Skylyn Dr, Spartanburg, SC 29307-1041 | 2016-12-28 |
| 1457753378 | Ramona R Hrysikos | Registered Nurse | 1700 Skylyn Dr, Spartanburg, SC 29307-1041 | 2014-09-23 |
| 1104166511 | Angela Mills Steward | Registered Nurse | 1700 Skylyn Dr, Spartanburg, SC 29307-1041 | 2013-02-21 |
| 1528303005 | Bonnie Boswell Boone | Lactation Consultant, Non-RN | 1700 Skylyn Dr, Spartanburg, SC 29307-1041 | 2012-12-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023677945 | Healogics Specialty Physicians of South Carolina, LLC | Clinic/Center | 1630 Skylyn Drive, Suite 420, Spartanburg, SC 29307 | 2019-06-13 |
| 1194247528 | Tawnia Lee Prince | Occupational Therapy Assistant | 110 Summit Knoll Drive, Spartanburg, SC 29307 | 2017-07-07 |
| 1730633553 | Laura K Taylor | Chiropractor | 1802 Drayton Road, Suite 309, Spartanburg, SC 29307 | 2016-08-10 |
| 1013372390 | Erin Lavette Farr | Nurse Practitioner | 2780 East Main Street, Ltc Health Solutions, Spartanburg, SC 29307 | 2015-12-30 |
| 1316312010 | Joy Rogers | Speech-Language Pathologist | 175 Burdette St, Spartanburg, SC 29307 | 2015-12-07 |
| 1376923169 | Olivia Conrad | Speech-Language Pathologist | 220 Sloans Grove Rd, Spartanburg, SC 29307 | 2015-06-05 |
| 1457755118 | Optimal Radiology Partners of Virginia, Pllc | Radiology | 75 Skylyn Drive, Spartanburg, SC 29307 | 2014-10-09 |
| 1295033272 | Sean Quinn | Pharmacist | 790 East Main Street, Spartanburg, SC 29307 | 2011-03-01 |
| 1417250887 | James Edward Bradof | Internal Medicine | 212 Cypress Creek Drive, Spartanburg, SC 29307 | 2010-12-07 |
| 1528388030 | Tanya Tocharoen Tang | Internal Medicine | 126 Dillon Dr., Spartanburg, SC 29307 | 2010-06-07 |
| Find all providers in zip 29307 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033681630 | Spartanburg Medical Center | Psychiatric Unit | 1700 Skylyn Dr, Spartanburg, SC 29307-1041 | 2018-12-20 |
| 1649332453 | Stokes Jerome Smith Jr. | Psychiatric Unit | 101 E Wood St, Spartanburg, SC 29303-3040 | 2006-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326095324 | Prisma Health-midlands | Psychiatric Unit | 3301 Harden Street 11 Medical Park, Columbia, SC 29203-6897 | 2006-05-27 |
| 1598717316 | Prisma Health-midlands | Psychiatric Unit | 1330 Taylor At Marion Street, Columbia, SC 29201-0000 | 2006-05-17 |
| 1902864283 | The Regional Medical Center of Orangeburg and Calhoun Counties | Psychiatric Unit | 3000 St Matthews Rd, Orangeburg, SC 29118-1498 | 2006-05-03 |
| 1861996142 | Kershaw Hospital LLC | Psychiatric Unit | 1315 Roberts St, Camden, SC 29020-3737 | 2018-03-21 |
| 1972014728 | Grand Strand Regional Medical Center, LLC | Psychiatric Unit | 5050 Highway 17 Byp S, Myrtle Beach, SC 29588-4500 | 2017-10-19 |
| 1386038115 | Lancaster Hospital Corporation | Psychiatric Unit | 800 W Meeting St, Lancaster, SC 29720-2202 | 2015-03-18 |
| 1124443478 | Trident Medical Center, LLC | Psychiatric Unit | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2014-02-24 |
| 1376829952 | Walterboro Community Hospital, Inc. | Psychiatric Unit | 501 Robertson Blvd, Walterboro, SC 29488-2787 | 2011-10-27 |
| 1740314681 | Qhg of South Carolina Inc | Psychiatric Unit | 121 E Cedar St, Florence, SC 29506 | 2007-03-15 |
| 1598854507 | Thaddeus Paul Ozimek | Psychiatric Unit | 4500 Stuart Street, Moncrief Army Community Hospital, Fort Jackson, SC 29207-5720 | 2006-10-11 |
| Find all providers with the same taxonomy | ||||
| City | SPARTANBURG |
| Zip Code | 29307 |
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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.