Mary Black Physicians Group, LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MARY BLACK PHYSICIANS GROUP, LLC

Practice address

500 Squire's Pointe
Duncan, SC 29334-8867

Phone

(864) 433-8980

Fax

(864) 433-8982

NPI assigned

Oct 24, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

V Karen Flinn

Title

VP

Phone

(214) 473-3773

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Mary Black Physicians Group LLC

  • Durable Medical Equipment & Medical Supplies
  • Spartanburg, SC
  • NPI 1992925713

  Member Of

  NPD member

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295819415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SQUIRE'S POINTE",
            "city": "DUNCAN",
            "state": "SC",
            "postal_code": "293348867",
            "telephone_number": "864-433-8980",
            "fax_number": "864-433-8982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SQUIRE'S POINTE",
            "city": "DUNCAN",
            "state": "SC",
            "postal_code": "293348867",
            "telephone_number": "864-433-8980",
            "fax_number": "864-433-8982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY BLACK PHYSICIANS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FLINN",
        "authorized_official_first_name": "V",
        "authorized_official_middle_name": "KAREN",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "214-473-3773"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Hoang Mai, DMD
• Mary Black Health System LLC (Squires Pointe Medical Park)
• Mary Black Physician Services LLC
• Mary Black Physicians Group LLC
• Mary Black Physicians Group LLC
• Mary Black Physicians Group, LLC
• Mary Black Physicians Group, LLC
• Shdavia Asha McMillian, LPC
• Melanie Harley Dba Ot2Go (Ot2Go)
• Katherine E Morgenstern, PT

• Rural Health Clinic/Center in Duncan, SC
• Providers in Duncan, SC by specialty
• Rural Health Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.