Mary Black Physicians Group, LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MARY BLACK PHYSICIANS GROUP, LLC

Practice address

391 Glenn Springs Rd
Pacolet, SC 29372-2417

Phone

(864) 703-1414

Fax

(864) 703-1419

NPI assigned

Oct 19, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Addresses

Member of 1

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

• Mary Black Physicians Group LLC

  • Durable Medical Equipment & Medical Supplies
  • Spartanburg, SC
  • NPI 1992925713

  Member Of

  NPD member

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": "1902988983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 GLENN SPRINGS RD",
            "city": "PACOLET",
            "state": "SC",
            "postal_code": "293722417",
            "telephone_number": "864-703-1414",
            "fax_number": "864-703-1419"
        },
        {
            "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": "864-703-1414",
            "fax_number": "864-703-1419"
        }
    ],
    "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey L Jackson, LPC
• Amanda Rae Johnson, PHARM.D.
• Kameron Burke Klosterman, MD
• Mary Black Health System LLC (Foothills Family Medicine)
• Mary Black Physicians Group LLC
• Eric McEntire
• Pacolet Mills Rescue Squad, Inc
• Jessica Leanne Parris Weathers, RMA
• Rachael Pratt, D.C.
• Carolyn Pauline Privette, LISW-CP

• Rural Health Clinic/Center in Pacolet, SC
• Providers in Pacolet, SC by specialty
• Rural Health Clinic/Center in South Carolina

• 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.