MARY BLACK PHYSICIAN SERVICES LLC
NPI 1811950645
Nurse Practitioner in Duncan, SC

Q: What is Mary Black Physician Services LLC's NPI number?

The NPI number for Mary Black Physician Services LLC is 1811950645. It was assigned to this organization in the NPPES registry on April 11, 2006.

Q: What is Mary Black Physician Services LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since April 11, 2006

170 RIDGEVIEW CENTER DR, DUNCAN, SC 29334(864) 573-3124(864) 582-5188 Get Directions Write a Review

NPPES record last updated: June 20, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 20, 2018, Mar 17, 2018, Jan 12, 2018 (3 updates tracked since 2018).

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About Mary Black Physician Services Llc NPPES

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

MARY BLACK PHYSICIAN SERVICES LLC (NPI 1811950645) is a healthcare organization registered as a nurse practitioner in Duncan, South Carolina and active in the NPI registry since April 2006. The organization maintains a secondary practice location in Gaffney and lists Tammy V Mccollum, Business Office Director, as its authorized official.

NPPES Registry Identity

NPI1811950645

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NameMARY BLACK PHYSICIAN SERVICES LLC

Location Address170 RIDGEVIEW CENTER DRDuncan, SC 29334-9635

Mailing Address145b Dillon DrSpartanburg, SC 29307-1017 · (865) 253-8063 · Fax (864) 582-5188

Phone(864) 573-3124

Fax(864) 582-5188

Organization SubpartNo

Authorized OfficialTammy V MccollumBusiness Office Director · (864) 253-8063

Enumeration DateApril 11, 2006

Last NPPES UpdateJune 20, 20183 updates tracked since enumeration

✔ NPI 1811950645 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedOrthopaedic SurgeryTaxonomy 207X00000X

Also ListedPhysician AssistantTaxonomy 363A00000X

170 RIDGEVIEW CENTER DR, Duncan, SC 29334

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Secondary Practice Location 1

Location 1724 Hyatt St, Ste. FGaffney, SC 29341-2630 · Phone (864) 488-2507

Other Identifiers 5

MedicaidGP4169SC

MedicaidGP4353SC

Other800572901Tax Id

MedicaidGP4168SC

MedicaidGP4319SC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 Physician Services LLC's NPI number?

The NPI number for Mary Black Physician Services LLC is 1811950645. It was assigned to this organization in the NPPES registry on April 11, 2006.

Where is Mary Black Physician Services LLC located?

Mary Black Physician Services LLC is located at 170 Ridgeview Center Dr, Duncan, SC 29334. The listed phone number is (864) 573-3124.

What is Mary Black Physician Services LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Mary Black Physician Services LLC was last updated on June 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.