MARY BLACK PHYSICIANS GROUP, LLC (NPI# 1326283896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326283896 |
| Entity Type | Organization |
| Organization Name | MARY BLACK PHYSICIANS GROUP, LLC |
| Other Organization Name | PIEDMONT INTERNAL MEDICINE-WESTSIDE |
| Practice Address |
2995 Reidville Rd Suite 210 Spartanburg SC 29301-5628 |
| Mailing Address |
Po Box 277827 Atlanta GA 30384-7827 |
| Practice Telephone | 8645967424 |
| Mailing Telephone | 8642538080 |
| 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 | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP4764 | 05 |
| Other Name | Type Code |
|---|---|
| Piedmont Internal Medicine-Westside | 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 |
| 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 |
| 1104061688 | Mary Black Physicians Group, LLC | Emergency Medicine | 2995 Reidville Rd, Spartanburg, SC 29301-5628 | 2008-12-11 |
| Street Address |
2995 REIDVILLE RD SUITE 210 |
| 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 |
| 1104061688 | Mary Black Physicians Group, LLC | Emergency Medicine | 2995 Reidville Rd, Spartanburg, SC 29301-5628 | 2008-12-11 |
| 1306081880 | Mary Black Physicians Group, LLC | Family Medicine | 2995 Reidville Rd, Suite 260, 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902338742 | Purav Patel | Internal Medicine | 101 E Wood St Ste 101, Spartanburg, SC 29303-3040 | 2017-03-31 |
| 1740670181 | Ernest Arnold | Internal Medicine | 225 Swansea Rd, Spartanburg, SC 29307-3826 | 2015-01-23 |
| 1942594155 | Michael S Humeniuk | Internal Medicine | 380 Serpentine Dr Ste 200, Spartanburg, SC 29303-3066 | 2011-06-06 |
| 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 |
| 1427214618 | John H. Brooks, M.d. - Allergy & Asthma | Internal Medicine | 2375 E. Main St., Suite A-204, Spartanburg, SC 29307 | 2008-08-06 |
| 1902851710 | Stanley D Miller | Internal Medicine | 1690 Skylyn Dr Ste 300b, Spartanburg, SC 29307-1022 | 2006-05-23 |
| 1578516399 | Thomas L Robinson | Internal Medicine | 118 Dillon Dr, Spartanburg, SC 29307-1018 | 2006-05-19 |
| 1548219819 | James Jasper Harber IIi | Internal Medicine | 1530 Drayton Road, Spartanburg, SC 29307-1058 | 2006-05-06 |
| 1801851290 | Helen M. Stockinger | Internal Medicine | 101 E Wood St Ste 401, Spartanburg, SC 29303-3040 | 2006-04-19 |
| 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.