Active NPI
Mary Black Health System LLC
- Gastroenterology Physician
- Spartanburg, SC
National Provider Identifier
1689697807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- Legal business name
- MARY BLACK HEALTH SYSTEM LLC
- Practice address
- 11 Doctors Park Dr
Spartanburg, SC 29307-1024 - Phone
- (864) 342-1435
- NPI assigned
- Jul 26, 2006
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Rebecca Hurley
- Title
- Senior Vice President
- Phone
- (214) 473-3993
National Provider Directory
National Provider DirectorySpecialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | |||
| Gastroenterology Physician | 207RG0100X | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
11 Doctors Park Dr
Spartanburg, SC 29307-1024
Mailing address
11 Doctors Park Dr
Spartanburg, SC 29307-1024
Phone (864) 342-1435
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP1874 | Medicaid | SC |
Other names 1
NPPES NPI Registry- Mary Black Gastroenterology Associates
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 11, 2025.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1689697807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 DOCTORS PARK DR",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293071024",
"telephone_number": "864-342-1435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 DOCTORS PARK DR",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293071024",
"telephone_number": "864-342-1435"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARY BLACK HEALTH SYSTEM LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-26",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "HURLEY",
"authorized_official_first_name": "REBECCA",
"authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
"authorized_official_telephone_number": "214-473-3993"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP1874",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Mary Black Gastroenterology Associates",
"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 Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.