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Organization Active NPI

Mary Black Health System LLC

Doing business as Mary Black Health System Spartanburg

  • Rehabilitation Hospital Unit
  • Spartanburg, SC
National Provider Identifier
1245283589
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
HTL-704 Issued in SC
Legal business name
MARY BLACK HEALTH SYSTEM LLC
Doing business as
Mary Black Health System Spartanburg
Practice address
1700 Skylyn Dr
Spartanburg, SC 29307-1041
Phone
(864) 573-3000
Fax
(864) 573-3277
NPI assigned
May 18, 2006
Last updated
Feb 22, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
MARY BLACK HEALTH SYSTEM LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

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

Authorized official

Name
Paula Lalor
Title
Director/Delegated Official
Phone
(615) 925-4565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X HTL-704 SC Primary

Addresses

Primary practice location

1700 Skylyn Dr
Spartanburg, SC 29307-1041

Mailing address

1700 Skylyn Dr
PO Box 3217
Spartanburg, SC 29304
Phone (864) 573-3000

Other identifiers 2

IdentifierTypeStateIssuer
382184MedicaidSC
400836MedicaidSC

Other names 1

  • Mary Black Health System Spartanburg Doing business as

National Provider Directory

National Provider Directory
Part of
Spartanburg Surgical CL

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519257600000",
    "number": "1245283589",
    "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": "29304",
            "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": "YES",
        "parent_organization_legal_business_name": "MARY BLACK HEALTH SYSTEM LLC",
        "enumeration_date": "2006-05-18",
        "last_updated": "2018-02-22",
        "status": "A",
        "authorized_official_last_name": "LALOR",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "DIRECTOR/DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "615-925-4565"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "SC",
            "license": "HTL-704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382184",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400836",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Black Health System Spartanburg",
            "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 Feb 22, 2018; 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.