JUSTIN CLINT BLACK (NPI# 1508206285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508206285 |
| Entity Type | Individual |
| Full Name | JUSTIN CLINT BLACK |
| Credential | MD |
| Practice Address |
101 E Wood St Spartanburg SC 29303-3040 |
| Mailing Address |
6000 Troon Cir Apt 14 Boiling Springs SC 29316-6322 |
| Practice Telephone | 8645606000 |
| Mailing Telephone | 8283209122 |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2013-06-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | LL35690 | SC | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982903290 | Justin Frederick Black | Physical Medicine & Rehabilitation | 301 Main Plz # 170, New Braunfels, TX 78130-5136 | 2011-03-25 |
| 1326420035 | Justin Black | Social Worker | 420 N James Rd, Columbus, OH 43219-1834 | 2015-06-18 |
| 1740436781 | Justin Ray Black | Anesthesiology | 5841 S Maryland Ave # Mc4028, Chicago, IL 60637-1447 | 2008-08-11 |
| Street Address |
101 E WOOD ST |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29303-3040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407858467 | Steven William Corso | Internal Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2005-06-02 |
| 1932713203 | Warren Everett Evans | Surgery | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-09-03 |
| 1023628096 | Zoe Kyle | Nurse Practitioner | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-08-05 |
| 1952928897 | Marcus Kyle Mauney | Registered Nurse | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-26 |
| 1679198618 | Raymond Briggs Westby | Surgery | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-16 |
| 1477178754 | Brewer Mccann Carter | Surgery | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-11 |
| 1982229704 | Kathryn Dewalt Rubel | Nurse Anesthetist, Certified Registered | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-09 |
| 1255956074 | Benjamin Todd Reeves | Internal Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-09 |
| 1952926685 | Mason Runge | Internal Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-09 |
| 1013531045 | Ryan Scott Rhodes | Internal Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013532126 | Adam Joseph Fulcher | Family Medicine | Center for Family Medicine, 853 N. Church Street, Suite 510, Spartanburg, SC 29303 | 2020-06-15 |
| 1275011652 | Tri-state Medical Supplies, North Grove | Durable Medical Equipment & Medical Supplies | 1330 Boiling Springs Rd Ste 2900, Spartanburg, SC 29303 | 2018-07-30 |
| 1992227151 | Roxanne Pope | Speech-Language Pathologist | 290 N Grove Medical Park Dr., Spartanburg, SC 29303 | 2017-07-10 |
| 1861934879 | Cortney Redmond Mckinney I | Counselor | 250 Dewey Sve., Spartanburg, SC 29303 | 2016-11-08 |
| 1578011474 | Instride Foot and Ankle Specialists, Pllc | Podiatrist | 269 North Grove Medical Drive, Spartanburg, SC 29303 | 2016-09-20 |
| 1023477536 | Whitney Brooke Terry | Physician Assistant | 391 Serpentine Dr Ste 250, Spartanburg, SC 29303 | 2016-02-12 |
| 1306244348 | Medcare Urgent Care Spartanburg, LLC | Clinic/Center | 301 E Wood Street, Spartanburg, SC 29303 | 2014-12-08 |
| 1508201393 | Tom Ju | Anesthesiology | 1330 Boiling Springs Rd Ste 2700, Spartanburg, SC 29303 | 2013-05-07 |
| 1295072312 | Marie O'dell | Registered Nurse | 7 698 Howard Street, Spartanburg School District, Spartanburg, SC 29303 | 2013-01-09 |
| 1518203330 | Sherard Hamilton Ansley | Speech-Language Pathologist | 698 Howard St., Spartanburg School District 7, Spartanburg, SC 29303 | 2012-12-26 |
| Find all providers in zip 29303 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760903793 | Samuel Ostrum | General Practice | 101 E Wood St, Spartanburg, SC 29303-3040 | 2017-06-29 |
| 1386164671 | Jeffrey Kyle Cooper | General Practice | 101 E Wood St, Spartanburg, SC 29303-3040 | 2017-06-27 |
| 1518317569 | Bradley Aaron Cagle | General Practice | 101 E Wood St, Spartanburg, SC 29303-3040 | 2016-06-20 |
| 1366857930 | Nancy Ballantyne | General Practice | 101 E Wood St, Spartanburg, SC 29303-3040 | 2014-06-23 |
| 1104892165 | Randall Steve Stewart | General Practice | 2995 Reidville Rd Ste 100, Spartanburg, SC 29301-5600 | 2006-02-28 |
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| Find all providers with the same taxonomy | ||||
| City | SPARTANBURG |
| Zip Code | 29303 |
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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.