1. Home
  2. Directory
  3. South Carolina
  4. Chesnee
  5. Family Medicine
  6. NPI Profile

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: August 16, 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 2 active CLIA laboratory certificates 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
Phone(864) 703-1414
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
Open in Google Maps ↗

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 Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 42D0898281

Chesnee Center For Family Medicine - Spartanburg Reg Hlth System · Chesnee, SC
Active · expires Sep 20, 2026
CLIA Number42D0898281
Laboratory TypePhysician Office
Certificate Effective DateSeptember 21, 2024
Certificate Expiration DateSeptember 20, 2026
Laboratory DirectorDr. Brian J. Mulroy
Laboratory Phone(864) 560-1563
Laboratory LocationChesnee Center For Family Medicine - Spartanburg Reg Hlth System702 S Alabama Avenue, Chesnee, SC 29323
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 42D2118502

Chesnee Center For Family Medicine Faculty Group · Chesnee, SC
Active · expires Sep 8, 2026
CLIA Number42D2118502
Laboratory TypePhysician Office
Certificate Effective DateSeptember 9, 2024
Certificate Expiration DateSeptember 8, 2026
Laboratory DirectorBrian Mulroy
Laboratory Phone(864) 560-9100
Laboratory LocationChesnee Center For Family Medicine Faculty Group702 South Alabama Ave, Chesnee, SC 29323
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RIANNA SONNY KONDAVEETI D.O
Family Medicine
702 S ALABAMA AVE
CHESNEE, SC 29323
Spartanburg County (864) 560-9100
MARY BLACK PHYSICIANS GROUP, LLC
Clinic/Center (Rural Health)
702 S ALABAMA AVE
CHESNEE, SC 29323
Spartanburg County (864) 703-1414
MARY BLACK PHYSICIANS GROUP LLC
Durable Medical Equipment & Medical Supplies
702 S ALABAMA AVE
CHESNEE, SC 29323
Spartanburg County (864) 703-1419

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Black Physicians Group, LLC's NPI number?

The NPI number for Mary Black Physicians Group, LLC is 1043455520. It was assigned to this organization in the NPPES registry on December 11, 2008. The provider is also known as Chesnee.

Where is Mary Black Physicians Group, LLC located?

Mary Black Physicians Group, LLC is located at 702 S Alabama Ave, Chesnee, SC 29323. The listed phone number is (864) 703-1414.

What is Mary Black Physicians Group, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Mary Black Physicians Group, LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Mary Black Physicians Group, LLC was last updated on December 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.