NPIMap

Organization Active NPI

Emary Black Physicians Group, LLC

  • Family Medicine Physician
  • Pacolet, SC
National Provider Identifier
1760627244
Registry record updated Dec 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EMARY BLACK PHYSICIANS GROUP, LLC
Practice address
391 Glenn Springs Rd
Pacolet, SC 29372-2417
Phone
(864) 474-3013
NPI assigned
Dec 11, 2008
Organization subpart
Yes
Parent organization
MARY BLACK PHYSICIANS GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2008

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

Authorized official

Name
Debbie Brewer
Title
Director Provider Enrollment
Phone
(615) 465-7626

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

391 Glenn Springs Rd
Pacolet, SC 29372-2417

Mailing address

PO Box 277827
Atlanta, GA 30384-7827
Phone (615) 465-7626

Other identifiers 1

IdentifierTypeStateIssuer
GP4782MedicaidSC

Other names 1

  • Foothills Family-Pacolet Other name

National Provider Directory

National Provider Directory
Tax ID family
Mary Black Physicians Group33 organizations share this tax ID, including this one
Part of
Mary Black Physicians Group

Other organizations with this tax ID 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1228953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228953600000",
    "number": "1760627244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277827",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847827",
            "telephone_number": "615-465-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 GLENN SPRINGS RD",
            "city": "PACOLET",
            "state": "SC",
            "postal_code": "293722417",
            "telephone_number": "864-474-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMARY BLACK PHYSICIANS GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARY BLACK PHYSICIANS GROUP, LLC",
        "enumeration_date": "2008-12-11",
        "last_updated": "2008-12-11",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "DIRECTOR PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "615-465-7626"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4782",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foothills Family-Pacolet",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pacolet, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; 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.