NPIMap

Organization Active NPI

Mary Black Health System, LLC

  • Durable Medical Equipment & Medical Supplies
  • Spartanburg, SC
National Provider Identifier
1053428631
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MARY BLACK HEALTH SYSTEM, LLC
Practice address
1690 Skylyn Dr Ste 140
Spartanburg, SC 29307-1036
Phone
(864) 591-1664
NPI assigned
Aug 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rebecca Hurley
Title
Sr VP
Phone
(214) 473-3993

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1690 Skylyn Dr Ste 140
Spartanburg, SC 29307-1036

Mailing address

138 Dillon Dr Ste a
Spartanburg, SC 29307-1018
Phone (864) 542-8980

Other identifiers 1

IdentifierTypeStateIssuer
GP1597MedicaidSC

Other names 1

  • Upstate Surgical Associates Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1053428631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 DILLON DR STE A",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071018",
            "telephone_number": "864-542-8980",
            "fax_number": "864-515-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 SKYLYN DR STE 140",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071036",
            "telephone_number": "864-591-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY BLACK HEALTH SYSTEM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "HURLEY",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "SR VP",
        "authorized_official_telephone_number": "214-473-3993"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1597",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Upstate Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.