MARY BLACK HEALTH SYSTEM LLC (NPI# 1669425963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669425963 |
| 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 29307-1041 |
| Practice Telephone | 8645733000 |
| Practice Fax Number | 8645733277 |
| Mailing Telephone | 8645733000 |
| Mailing Fax Number | 8645733277 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2018-02-14 |
| Authorized Official Name | PAULA LALOR (DIREDTOR/DELEGATED OFFICIAL) |
| Authorized Official Telephone | 6159254565 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | HTL-704 | SC | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 382184 | 05 | |
| SC | 400836 | 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 | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699790485 | Spartanburg Hospital for Restorative Care | General Acute Care Hospital | 389 Serpentine Dr, Spartanburg, SC 29303-3026 | 2006-07-13 |
| 1902352008 | Prisma Health-upstate | General Acute Care Hospital | 120 Dillon Dr, Spartanburg, SC 29307-1018 | 2016-08-29 |
| 1629432869 | Prisma Health-upstate | General Acute Care Hospital | 1413 John B White Sr Blvd, Suite D, Spartanburg, SC 29306-3995 | 2016-04-13 |
| 1518376342 | Spartanburg Regional Healthcare Systems | General Acute Care Hospital | 101 E. Wood Street, Spartanburg, SC 29303-3098 | 2014-08-06 |
| 1275953218 | Greenville Health System | General Acute Care Hospital | 120 Dillon Dr, Spartanburg, SC 29307-1018 | 2014-04-17 |
| 1790001659 | Spartanburg Regional | General Acute Care Hospital | 853 N Church St Ste 510, Spartanburg, SC 29303-3077 | 2010-04-15 |
| 1285891960 | Lung and Chest Medical Associates | General Acute Care Hospital | 2030 North Church Place, Spartanburg, SC 29303 | 2008-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760963243 | Prisma Health-upstate | General Acute Care Hospital | 112 John St Ste 104, Easley, SC 29640-1405 | 2018-08-23 |
| 1578044053 | Prisma Health-upstate | General Acute Care Hospital | 11402 Anderson Rd Ste B, Greenville, SC 29611-7560 | 2018-08-23 |
| 1790264497 | Prisma Health-upstate | General Acute Care Hospital | 11404 Anderson Rd, Greenville, SC 29611 | 2018-08-13 |
| 1275066821 | Travis B Grindstaff | General Acute Care Hospital | 411 Polifka Dr, Shaw Afb, SC 29152 | 2017-04-10 |
| 1710428321 | Palmetto Health Usc Medical Group | General Acute Care Hospital | Taylor Marion Sts, Columbia, SC 29220-0001 | 2017-03-15 |
| 1003351859 | Palmetto Health | General Acute Care Hospital | 808 Kawana Rd, Columbia, SC 29205-2033 | 2017-01-04 |
| 1548716665 | Upstate Affiliate Organization | General Acute Care Hospital | 200 Andrews St, Suite 100, Greenville, SC 29601-3969 | 2016-08-29 |
| 1932554466 | Palmetto Health Richland | General Acute Care Hospital | 5 Medical Park Rd., Columbia, SC 29203-6863 | 2016-05-03 |
| 1952756124 | University of Florida | General Acute Care Hospital | 1537 Theresa Dr, Apt A, Charleston, SC 29412-3242 | 2016-04-25 |
| 1831550060 | Lexington Medical Center | General Acute Care Hospital | 146 N Hospital Dr Ste 310, West Columbia, SC 29169-4800 | 2016-03-16 |
| 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.