NPIMap

Organization Active NPI

Mary Black Physicians Group, LLC

  • Rural Health Clinic/Center
  • Gaffney, SC
National Provider Identifier
1700968781
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MARY BLACK PHYSICIANS GROUP, LLC
Practice address
722 Hyatt St
Gaffney, SC 29341-2643
Phone
(864) 489-2400
Fax
(864) 489-7788
NPI assigned
Oct 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

722 Hyatt St
Gaffney, SC 29341-2643

Mailing address

722 Hyatt St
Gaffney, SC 29341-2643
Phone (864) 489-2400

National Provider Directory

National Provider Directory

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700968781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 HYATT ST",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293412643",
            "telephone_number": "864-489-2400",
            "fax_number": "864-489-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 HYATT ST",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293412643",
            "telephone_number": "864-489-2400",
            "fax_number": "864-489-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY BLACK PHYSICIANS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 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.