Mary Black Health System, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MARY BLACK HEALTH SYSTEM, LLC

Doing business as

Glace & Norton Family Pracitice

Practice address

2995 Reidville Rd Ste 260
Spartanburg, SC 29301-5667

Phone

(864) 574-2866

NPI assigned

Aug 7, 2006

Last updated

Aug 14, 2007By the provider in NPPES

Organization subpart

Yes

Parent organization

MARY BLACK HEALTH SYSTEM, LLCAs reported in NPPES

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

Addresses

Other identifiers 1

Other names 1

• Glace & Norton Family Pracitice Doing business as

Part of

Spartanburg Surgical CL

Locations

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187049600000",
    "number": "1629087754",
    "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": "2995 REIDVILLE RD STE 260",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293015667",
            "telephone_number": "864-574-2866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY BLACK HEALTH SYSTEM, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARY BLACK HEALTH SYSTEM, LLC",
        "enumeration_date": "2006-08-07",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1608",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glace & Norton Family Pracitice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Black Health System, LLC (Piedmont Internal Medicine)
• Mary Black Health System, LLC (Bass Urology)
• Mary Black Health System, LLC (Carolina OB/GYN)
• Mary Black Health System, LLC (Peachview Physical Therapy)
• Mary Black Health System, LLC (Pediatric Associates)
• Mary Black Health System, LLC (Carolina OB/GYN)
• Mary Black Health System, LLC (Family Physicains of Spartanburg)
• Mary Black Health System, LLC (Kiesau Gynecology Associates)
• Mary Black Health System, LLC (Family Medical Center)
• Mary Black Health System, LLC (Piedmont Internal Medicine)

• Family Medicine Physician in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Family Medicine Physician in South Carolina

• 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.