CHESNEE
NPI 1043455520
Family Medicine in Chesnee, SC

Active since December 11, 2008CLIA Certified · 2 labs
702 S ALABAMA AVE, CHESNEE, SC 29323(864) 703-1414 Get Directions Write a Review

NPPES record last updated: December 11, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Chesnee NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHESNEE (NPI 1043455520) is a healthcare organization registered as a family medicine in Chesnee, South Carolina and active in the NPI registry since December 2008. The organization holds an CLIA Accreditation certificate valid through September 20, 2026 and lists Debbie Brewer, Director Provider Enrollment, as its authorized official.

NPPES Registry Identity

NPI1043455520
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMARY BLACK PHYSICIANS GROUP, LLC
Location Address702 S ALABAMA AVEChesnee, SC 29323-1706
Mailing AddressPo Box 277827Atlanta, GA 30384-7827 · (864) 253-8063 · Fax (864) 582-5188
Organization SubpartYes
Authorized OfficialDebbie BrewerDirector Provider Enrollment · (645) 465-7626
Enumeration DateDecember 11, 2008
NPI 1043455520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

702 S ALABAMA AVE, Chesnee, SC 29323

Other Names 1

Other NameChesnee

Other Identifiers 2

MedicaidGP4774SC
Medicare PIN8688SC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
42D0898281
Facility Type
Physician Office
Certificate Effective Date
September 21, 2024
Certificate Expiration Date
September 20, 2026
Laboratory Director
DR. BRIAN J. MULROY
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Chesnee on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Durable Medical Equipment & Medical Supplies
702 S ALABAMA AVE
CHESNEE, SC 29323
Clinic/Center (Rural Health)
702 S ALABAMA AVE
CHESNEE, SC 29323
Family Medicine
702 S ALABAMA AVE
CHESNEE, SC 29323

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043455520, enumerated as an "organization" on December 11, 2008.

The provider is located at 702 S ALABAMA AVE CHESNEE, SC 29323 and the phone number is (864) 703-1414.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.