NPIMap

Organization Active NPI

Mary Black Physicians Group LLC

  • Rural Health Clinic/Center
  • Union, SC
National Provider Identifier
1962584938
Registry record updated Aug 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MARY BLACK PHYSICIANS GROUP LLC
Doing business as
Carolina Internal Medicine of Union
Practice address
1005 Thompson Blvd
Union, SC 29379-7409
Phone
(864) 427-9311
Fax
(864) 427-9309
NPI assigned
Oct 19, 2006
Organization subpart
Yes
Parent organization
MARY BLACK PHYSICIANS GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2008

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

Authorized official

Name
Debbie T Brewer
Title
Director
Phone
(877) 892-9813

Specialties & licenses 1

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

Addresses

Primary practice location

1005 Thompson Blvd
Union, SC 29379-7409

Mailing address

1005 Thompson Blvd
Union, SC 29379-7409
Phone (864) 427-9311

Other names 1

  • Carolina Internal Medicine of Union Doing business as

National Provider Directory

National Provider Directory
Part of
Mary Black Physicians Group

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": "1218499200000",
    "number": "1962584938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 THOMPSON BLVD",
            "city": "UNION",
            "state": "SC",
            "postal_code": "293797409",
            "telephone_number": "864-427-9311",
            "fax_number": "864-427-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 THOMPSON BLVD",
            "city": "UNION",
            "state": "SC",
            "postal_code": "293797409",
            "telephone_number": "864-427-9311",
            "fax_number": "864-427-9309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY BLACK PHYSICIANS GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARY BLACK PHYSICIANS GROUP LLC",
        "enumeration_date": "2006-10-19",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "877-892-9813"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Internal Medicine of Union",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Union, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.