NPIMap

Organization Active NPI

Mary Black Health System LLC

Doing business as Mary Black Memorial Hospital

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
National Provider Identifier
1083640981
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
MARY BLACK HEALTH SYSTEM LLC
Doing business as
Mary Black Memorial Hospital
Practice address
1700 Skylyn Dr
Spartanburg, SC 29307-1041
Phone
(864) 573-3000
Fax
(864) 573-3277
NPI assigned
Jun 23, 2006
Last updated
Sep 11, 2025By the provider in NPPES
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
Senior Vice President
Phone
(214) 473-3993

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X HTL-704 SC
Clinical Cardiac Electrophysiology Physician 207RC0001X HTL-704 SC
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

1700 Skylyn Dr
Spartanburg, SC 29307-1041

Mailing address

1700 Skylyn Dr
PO Box 3217
Spartanburg, SC 29307-1041
Phone (864) 573-3000

Other identifiers 1

IdentifierTypeStateIssuer
GP1764MedicaidSC

Other names 1

  • Mary Black Memorial Hospital Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 66

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 66

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1083640981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SKYLYN DR",
            "address_2": "PO BOX 3217",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071041",
            "telephone_number": "864-573-3000",
            "fax_number": "864-573-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SKYLYN DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071041",
            "telephone_number": "864-573-3000",
            "fax_number": "864-573-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY BLACK HEALTH SYSTEM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "HURLEY",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "214-473-3993"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "HTL-704",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "SC",
            "license": "HTL-704",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1764",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Black Memorial Hospital",
            "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.