MARY BLACK PHYSICIANS GROUP, LLC (NPI# 1306081880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306081880 |
| Entity Type | Organization |
| Organization Name | MARY BLACK PHYSICIANS GROUP, LLC |
| Other Organization Name | GLACE & NORTON |
| Practice Address |
2995 Reidville Rd Suite 260 Spartanburg SC 29301-5628 |
| Mailing Address |
Po Box 277827 Atlanta GA 30384-7827 |
| Practice Telephone | 8645742866 |
| Mailing Telephone | 8642538063 |
| Mailing Fax Number | 8645825188 |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2008-12-11 |
| Authorized Official Name | DEBBIE BREWER (DIRECTOR PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 6154657626 |
| Is Organization Subpart | Y |
| Parent Organization Name | MARY BLACK PHYSICIANS GROUP, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP4776 | 05 |
| Other Name | Type Code |
|---|---|
| Glace & Norton | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295819415 | Mary Black Physicians Group, LLC | Clinic/Center | 500 Squire's Pointe, Duncan, SC 29334-8867 | 2006-10-24 |
| 1669554630 | Mary Black Physicians Group, LLC | Clinic/Center | 702 S Alabama Ave, Chesnee, SC 29323-1706 | 2006-10-19 |
| 1013152669 | Mary Black Physicians Group, LLC | Internal Medicine | 1690 Skylyn Dr, Suite 300, Spartanburg, SC 29307-1022 | 2008-12-11 |
| 1962647438 | Mary Black Physicians Group, LLC | Family Medicine | 1690 Skylyn Dr, Suite 210, Spartanburg, SC 29307-1022 | 2008-12-11 |
| 1598900078 | Mary Black Physicians Group, LLC | Family Medicine | 722 Hyatt St, Suite C, Gaffney, SC 29341-2643 | 2008-12-11 |
| 1487899969 | Mary Black Physicians Group, LLC | Pediatrics | 500 Squires Pt, Suite A, Duncan, SC 29334-8867 | 2008-12-11 |
| 1740425222 | Mary Black Physicians Group, LLC | Physical Medicine & Rehabilitation | 1700 Skylyn Dr, Spartanburg, SC 29307-1041 | 2008-12-11 |
| 1326283896 | Mary Black Physicians Group, LLC | Internal Medicine | 2995 Reidville Rd, Suite 210, Spartanburg, SC 29301-5628 | 2008-12-11 |
| 1053556522 | Mary Black Physicians Group, LLC | Family Medicine | 1250 John B White Sr Blvd, Spartanburg, SC 29306-3929 | 2008-12-11 |
| 1295970770 | Mary Black Physicians Group, LLC | Surgery | 1690 Skylyn Dr, Suite 140, Spartanburg, SC 29307-1022 | 2008-12-11 |
| Street Address |
2995 REIDVILLE RD SUITE 260 |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29301-5628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881659712 | Royal Albert Hobbs | Plastic Surgery | 2995 Reidville Rd, Suite 150, Spartanburg, SC 29301-5668 | 2006-04-20 |
| 1619339660 | Mary Black Physicians Group LLC | Durable Medical Equipment & Medical Supplies | 2995 Reidville Rd, Spartanburg, SC 29301-5628 | 2016-03-28 |
| 1861817819 | Lettie Jane Haynes | Nurse Practitioner | 2995 Reidville Rd, Spartanburg, SC 29301-5628 | 2014-02-27 |
| 1619310844 | Precision Plastic Surgery Pa | Plastic Surgery | 2995 Reidville Rd, Suite 150, Spartanburg, SC 29301-5668 | 2013-04-08 |
| 1578806618 | Jessica L Heintzelman | Family Medicine | 2995 Reidville Rd, Suite 210, Spartanburg, SC 29301-5628 | 2013-03-27 |
| 1326283896 | Mary Black Physicians Group, LLC | Internal Medicine | 2995 Reidville Rd, Suite 210, Spartanburg, SC 29301-5628 | 2008-12-11 |
| 1104061688 | Mary Black Physicians Group, LLC | Emergency Medicine | 2995 Reidville Rd, Spartanburg, SC 29301-5628 | 2008-12-11 |
| 1053556191 | Mary Black Physicians Group LLC | Durable Medical Equipment & Medical Supplies | 2995 Reidville Rd, Spartanburg, SC 29301-5628 | 2008-12-03 |
| 1518112143 | Spartanburg Medical Center | Obstetrics & Gynecology | 2995 Reidville Rd, Suite 290, Spartanburg, SC 29301-5628 | 2008-11-24 |
| 1053511766 | Mary Black Physicians Group LLC | Durable Medical Equipment & Medical Supplies | 2995 Reidville Rd, Ste 290, Spartanburg, SC 29301-5628 | 2007-07-20 |
| Find all providers in the same location | ||||
| 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 | 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 |
|---|---|---|---|---|
| 1033716253 | Proactive Md Tindall Spartanburg Health Center | Family Medicine | 2273 Hayne St., Spartanburg, SC 29301 | 2020-10-01 |
| 1013532126 | Adam Joseph Fulcher | Family Medicine | Center for Family Medicine, 853 N. Church Street, Suite 510, Spartanburg, SC 29303 | 2020-06-15 |
| 1538713813 | Proactive Md Sc,p.a. | Family Medicine | 101 W Saint John St Ste 107, Spartanburg, SC 29306-5157 | 2019-07-25 |
| 1073171336 | Proactive Md Sc,p.a. | Family Medicine | 801 Union St, Spartanburg, SC 29302-2734 | 2019-06-03 |
| 1841757192 | Paladina Health, LLC | Family Medicine | Paladina Health Smith Drug, 9098 Fairforest Road, Spartanburg, SC 29301 | 2019-02-22 |
| 1487111738 | Paladina Health, LLC | Family Medicine | Paladina Health Spartanburg Palmetto Bank, 101 West Saint John Street Suite 107, Spartanburg, SC 29306 | 2019-02-22 |
| 1649735127 | Spartanburg Medical Center | Family Medicine | 11 Doctors Park Dr Ste 200, Spartanburg, SC 29307-1008 | 2019-02-08 |
| 1114403342 | Piedmont Care, Inc. | Family Medicine | 101 N Pine St Ste 200, Spartanburg, SC 29302-1604 | 2018-07-11 |
| 1356871933 | Kristy Kaye Atkinson | Family Medicine | 853 N Church St # 150, Spartanburg, SC 29303-3098 | 2017-06-15 |
| 1003352261 | Academic Primary Care Associates | Family Medicine | 410 Magnolia St, Spartanburg, SC 29303-3640 | 2017-01-12 |
| 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.