NPIMap

Organization Active NPI

Mary Black Health System LLC

Doing business as Peachview Radiology Center

  • Diagnostic Radiology Physician
  • Gaffney, SC
National Provider Identifier
1609983287
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MARY BLACK HEALTH SYSTEM LLC
Doing business as
Peachview Radiology Center
Practice address
724 Hyatt St Ste 2-D
Gaffney, SC 29341-2630
Phone
(864) 489-5001
NPI assigned
Aug 23, 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
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

724 Hyatt St Ste 2-D
Gaffney, SC 29341-2630

Mailing address

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

Other names 1

  • Peachview Radiology Center Doing business as

National Provider Directory

National Provider Directory
Part of
Mary Black Health

Locations

2995 Reidville Rd
Ste 130
Spartanburg, SC 29301
Phone (864) 587-3020

Practitioners & affiliated clinicians

Practitioners 7

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.

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": "1187049600000",
    "number": "1609983287",
    "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": "724 HYATT ST STE 2-D",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293412630",
            "telephone_number": "864-489-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY BLACK HEALTH SYSTEM LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARY BLACK HEALTH SYSTEM LLC",
        "enumeration_date": "2006-08-23",
        "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": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peachview Radiology Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gaffney, 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.