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DR. MARY LEWIS BLACK MD
NPI 1780716084
Pediatrics in Fort Gordon, GA

Active since March 12, 2007PECOS Enrolled
300 W HOSPITAL RD, FORT GORDON, GA 30905(706) 787-7300 Get Directions Write a Review

NPPES record last updated: November 17, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 17, 2025, Dec 7, 2018, Jan 5, 2017 (3 updates tracked since 2017).

About Dr. Mary Lewis Black Md NPPES

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

DR. MARY LEWIS BLACK MD (NPI 1780716084) is an individual pediatrics provider in Fort Gordon, Georgia, licensed in Georgia (059094) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780716084
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. MARY LEWIS BLACKCredential: MD
Location Address300 W HOSPITAL RDFort Gordon, GA 30905-5741
Mailing Address300 W Hospital RdFort Gordon, GA 30905-5741 · (706) 787-7300
Phone(706) 787-7300
Sole ProprietorNo
Enumeration DateMarch 12, 2007
Last NPPES UpdateNovember 17, 20253 updates tracked since enumeration
NPPES CertifiedNovember 17, 2025
✔ NPI 1780716084 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in GA · 059094
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
300 W HOSPITAL RD, Fort Gordon, GA 30905
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mary Lewis Black Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30905 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

DR. SCOTT WILLIAM BOYER P.T., DPT, OCS
Physical Therapist
300 W HOSPITAL RD
FORT GORDON, GA 30905
Richmond County (706) 787-1024
MS. JANIS C RAYNOR LCSW
Social Worker (Clinical)
300 W HOSPITAL RD, DDEAMC
FORT GORDON, GA 30905
Richmond County (706) 787-9186
DR. LEO MORRIS JOSEPH MD
Internal Medicine
300 W HOSPITAL RD
FORT GORDON, GA 30905
Richmond County (706) 787-2720
DANA JENKINS FNP
Nurse Practitioner (Adult Health)
300 W HOSPITAL RD, CONNELLY HEALTH CLINIC
FORT GORDON, GA 30905
Richmond County (706) 787-5161
DR. GREGORY J SENGSTOCK MD PHD
Psychiatry & Neurology (Vascular Neurology)
300 W HOSPITAL RD
FORT GORDON, GA 30905
Richmond County (706) 787-1335
DWIGHT D. EISENHOWER HOSPITAL, FORT GORDON
Military Hospital
300 W HOSPITAL RD
FORT GORDON, GA 30905
Richmond County (706) 787-2920
NEELY HUDSON PHARM.D.
Pharmacist
300 W HOSPITAL RD
FORT GORDON, GA 30905
Richmond County (706) 787-5811
BRENDA CLEVELAND
Registered Nurse (Pain Management)
300 W HOSPITAL RD
FORT GORDON, GA 30905
Richmond County (706) 787-2552

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's NPI number?

The NPI number for Mary Black is 1780716084. It was assigned to this individual provider in the NPPES registry on March 12, 2007.

Where is Mary Black located?

Mary Black practices at 300 W Hospital Rd, Fort Gordon, GA 30905. The listed phone number is (706) 787-7300.

What is Mary Black's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Mary Black enrolled in Medicare?

Yes. Mary Black is registered in the Medicare PECOS enrollment system.

What insurance does Mary Black accept?

Health plans from Alliant Health Plans, Inc. list Mary Black as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Black was last updated on November 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.