Organization Active NPI

Magnolia Primary Care LLC

  • Internal Medicine Physician
  • Huntsville, AL
National Provider Identifier
1013518265
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MAGNOLIA PRIMARY CARE LLC
Practice address
4101 Balmoral Dr SW Ste B
Huntsville, AL 35801-6535
Phone
(256) 203-6676
Fax
(833) 979-0980
NPI assigned
Nov 4, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Rohini Ramamoorthy, M.D.NPI 1265889448
Title
Physician
Phone
(256) 203-6676

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4101 Balmoral Dr SW Ste B
Huntsville, AL 35801-6535

Mailing address

4101 Balmoral Dr SW Ste B
Huntsville, AL 35801-6535
Phone (256) 203-6676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210115001604 AL Part B Supplier - Clinic/Group Practice 8224441084 Receives reassigned benefits from 1 practitioner
Practice locations: Huntsville, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2207362Magnolia Primary Care LLC4101 Balmoral Drive Suite B, Huntsville, AL 35801Certificate of waiverDec 27, 2026

National Provider Directory

National Provider Directory

Locations

4101 Balmoral Dr SW
Ste B
Huntsville, AL 35801
Phone (256) 203-3949

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1013518265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 BALMORAL DR SW STE B",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016535",
            "telephone_number": "256-203-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 BALMORAL DR SW STE B",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016535",
            "telephone_number": "256-203-6676",
            "fax_number": "833-979-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-04",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "RAMAMOORTHY",
        "authorized_official_first_name": "ROHINI",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "256-203-6676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.