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PEDIATRIC ASSOCIATES-EAST
NPI 1205071784
Pediatrics - Adolescent Medicine in Spartanburg, SC

Active since December 11, 2008
1686 SKYLYN DR STE 201, SPARTANBURG, SC 29307(864) 582-8135 Get Directions Write a Review

NPPES record last updated: December 11, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pediatric Associates-east NPPES

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

PEDIATRIC ASSOCIATES-EAST (NPI 1205071784) is a healthcare organization registered as an adolescent medicine in Spartanburg, South Carolina and active in the NPI registry since December 2008. The organization lists Debbie Brewer, Director Provider Enrollment, as its authorized official.

NPPES Registry Identity

NPI1205071784
Entity TypeOrganization
Primary Taxonomy2080A0000X
Legal Business NameMARY BLACK PHYSICIANS GROUP, LLC
Location Address1686 SKYLYN DR STE 201Spartanburg, SC 29307-1079
Mailing AddressPo Box 277827Atlanta, GA 30384-7827 · (864) 253-8063 · Fax (864) 582-5188
Phone(864) 582-8135
Organization SubpartYes
Authorized OfficialDebbie BrewerDirector Provider Enrollment · (615) 465-7626
Enumeration DateDecember 11, 2008
✔ NPI 1205071784 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
1686 SKYLYN DR STE 201, Spartanburg, SC 29307
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Other Names 1

Other NamePediatric Associates-east

Other Identifiers 1

MedicaidGP4779SC

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

Other Providers at the Same Location NPPES 2

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

SPARTANBURG MEDICAL CENTER
Obstetrics & Gynecology
1686 SKYLYN DR STE 201
SPARTANBURG, SC 29307
Spartanburg County (864) 560-6000
MARY BLACK HEALTH SYSTEM LLC
Obstetrics & Gynecology
1686 SKYLYN DR STE 201
SPARTANBURG, SC 29307
Spartanburg County (864) 585-3456

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 1205071784. It was assigned to this organization in the NPPES registry on December 11, 2008. The provider is also known as Pediatric Associates-East.

Where is Mary Black Physicians Group, LLC located?

Mary Black Physicians Group, LLC is located at 1686 Skylyn Dr Ste 201, Spartanburg, SC 29307. The listed phone number is (864) 582-8135.

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

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

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.