CHESNEE
NPI 1043455520
Family Medicine in Chesnee, SC
NPI Status: Active since December 11, 2008
Contact Information
702 S ALABAMA AVE
CHESNEE, SC
ZIP 29323
Phone: (864) 703-1414
- Organization
- Family Medicine
- CLIA Number: 42D0898281
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 09-20-2026
About CHESNEE
This page provides the complete NPI Profile along with additional information for Chesnee, a primary care provider established in Chesnee, South Carolina operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1043455520 assigned on December 2008. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 17 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's other name is Chesnee. The authorized official of this NPI record is Debbie Brewer (Director Provider Enrollment)
- NPI
- 1043455520
- Provider Legal Name
- MARY BLACK PHYSICIANS GROUP, LLC
- Other Organization Name
- CHESNEE
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 702 S ALABAMA AVE CHESNEE, SC 29323
- Location Phone
- (864) 703-1414
- Mailing Address
- PO BOX 277827 ATLANTA, GA 30384
- Mailing Phone
- (864) 253-8063
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 12-11-2008
- Last Update Date
- 12-11-2008
- Code Navigator
A primary care provider (PCP) like Chesnee sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| GP4774 | MEDICAID (05) | SC | |
| 8688 | MEDICARE PIN (08) | SC |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 42D0898281
- Facility Type
- Physician Office
- Certificate Effective Date
- September 21, 2024
- Certificate Expiration Date
- September 20, 2026
- Laboratory Director
- DR. BRIAN J. MULROY
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Chesnee on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
Reviews for CHESNEE
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 4 | 3 | 4 | 5 | 5 | 5 | 2 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 8 | 3 | 8 | 5 | 10 | 5 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 8 + 3 + 8 + 5 + 1 + 0 + 5 + 4 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1043455520 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1972721728 | MARY BLACK PHYSICIANS GROUP LLC Organization | Durable Medical Equipment & Medical Supplies | 702 S ALABAMA AVE CHESNEE, SC 29323 (864) 703-1419 |
| 1669554630 | MARY BLACK PHYSICIANS GROUP, LLC Organization | Clinic/Center (Rural Health) | 702 S ALABAMA AVE CHESNEE, SC 29323 (864) 703-1414 |
| 1154765006 | RIANNA SONNY KONDAVEETI D.O Individual | Family Medicine | 702 S ALABAMA AVE CHESNEE, SC 29323 (864) 560-9100 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1043455520, enumerated in the NPI registry as an "organization" on December 11, 2008
The provider is located at 702 S Alabama Ave Chesnee, Sc 29323 and the phone number is (864) 703-1414
This medical organization specializes in Family Medicine with taxonomy code 207Q00000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 42D0898281 for a "physician office" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on December 11, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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