NPIMap

Organization Active NPI

Mary Black Health System, LLC

Doing business as Peachview Physical Therapy

  • Pathology Specialist/Technologist
  • Spartanburg, SC
National Provider Identifier
1528075082
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pathology Specialist/TechnologistTaxonomy code 246Q00000X
Legal business name
MARY BLACK HEALTH SYSTEM, LLC
Doing business as
Peachview Physical Therapy
Practice address
138 Dillon Dr Ste a
Spartanburg, SC 29307-1018
Phone
(864) 542-8980
Fax
(864) 515-9994
NPI assigned
Aug 1, 2006
Last updated
Aug 14, 2007By 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 Aug 14, 2007

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

Authorized official

Name
Debbie Brewer
Title
Director of Provider Enrollment
Phone
(615) 465-7000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pathology Specialist/Technologist 246Q00000X NU Primary
Durable Medical Equipment & Medical Supplies 332B00000X NU

Addresses

Primary practice location

138 Dillon Dr Ste a
Spartanburg, SC 29307-1018

Mailing address

724 Hyatt St Ste F
Gaffney, SC 29341-2630
Phone (864) 542-8980

Other names 1

  • Peachview Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Spartanburg Surgical CL21 organizations share this tax ID, including this one
Part of
Spartanburg Surgical CL

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187049600000",
    "number": "1528075082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 HYATT ST STE F",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293412630",
            "telephone_number": "864-542-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY BLACK HEALTH SYSTEM, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARY BLACK HEALTH SYSTEM, LLC",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-08-14",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "615-465-7000"
    },
    "taxonomies": [
        {
            "code": "246Q00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peachview Physical Therapy",
            "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 Aug 14, 2007; 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.