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FAMILY MEDICAL CENTER
NPI 1124263694
Family Medicine in Spartanburg, SC

Active since December 11, 2008CLIA 42D0250006 · Waiver
130 DILLON DR, SPARTANBURG, SC 29307(864) 585-2027 Get Directions Write a Review

NPPES record last updated: December 11, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Family Medical Center NPPES

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

FAMILY MEDICAL CENTER (NPI 1124263694) is a healthcare organization registered as a family medicine in Spartanburg, South Carolina and active in the NPI registry since December 2008. The organization holds a CLIA Waiver certificate valid through October 31, 2026 and lists Debbie Brewer, Credentialing Supervisor, as its authorized official.

NPPES Registry Identity

NPI1124263694
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMARY BLACK PHYSICIANS GROUP, LLC
Location Address130 DILLON DRSpartanburg, SC 29307-1018
Mailing AddressPo Box 277827Atlanta, GA 30384-7827 · (864) 253-8080 · Fax (864) 582-5188
Phone(864) 585-2027
Organization SubpartYes
Authorized OfficialDebbie BrewerCredentialing Supervisor · (615) 465-7626
Enumeration DateDecember 11, 2008
✔ NPI 1124263694 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.
130 DILLON DR, Spartanburg, SC 29307
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Other Names 1

Other NameFamily Medical Center

Other Identifiers 2

MedicaidGP4768SC
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

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 Waiver 42D0250006

Family Medical Center & Infectious Disease - Skylyn · Spartanburg, SC
Active · expires Oct 31, 2026
CLIA Number42D0250006
Laboratory TypePhysician Office
Certificate Effective DateNovember 1, 2024
Certificate Expiration DateOctober 31, 2026
Laboratory DirectorStanley P. Miller MD
Laboratory Phone(864) 342-4000
Laboratory LocationFamily Medical Center & Infectious Disease - Skylyn1690 Skylyn Dr Suite 300A, Spartanburg, SC 29307
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

MARY BLACK PHYSICIANS GROUP LLC
Family Medicine
130 DILLON DR
SPARTANBURG, SC 29307
Spartanburg County (864) 585-2027
ORTHO SPORT & SPINE PHYSICIANS SPARTANBURG
Physical Medicine & Rehabilitation
130 DILLON DR
SPARTANBURG, SC 29307
Spartanburg County (678) 752-7246
ERBLAZ
General Practice
130 DILLON DR
SPARTANBURG, SC 29307
Spartanburg County (864) 365-3000
SUSAN D CASPER PA
Physician Assistant
130 DILLON DR
SPARTANBURG, SC 29307
Spartanburg County (800) 678-4611
MARY BLACK HEALTH SYSTEM, LLC
Family Medicine
130 DILLON DR
SPARTANBURG, SC 29307
Spartanburg County (864) 585-2027
MARY BLACK PHYSICIANS GROUP LLC
Durable Medical Equipment & Medical Supplies
130 DILLON DR
SPARTANBURG, SC 29307
Spartanburg County (864) 585-2027

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 1124263694. It was assigned to this organization in the NPPES registry on December 11, 2008. The provider is also known as Family Medical Center.

Where is Mary Black Physicians Group, LLC located?

Mary Black Physicians Group, LLC is located at 130 Dillon Dr, Spartanburg, SC 29307. The listed phone number is (864) 585-2027.

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 a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D0250006) is associated with this NPI, valid through October 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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 with the weekly NPPES data releases published by CMS.