MC Medical LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MC MEDICAL LLC

Doing business as

Walmart Health

Practice address

815 Shugart Rd
Dalton, GA 30720-2433

Phone

(706) 277-7661

Fax

(706) 277-7669

NPI assigned

Jul 22, 2014

Organization subpart

No

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

Authorized official

Name

Soujanya Pulluru

Title

President

Phone

(706) 277-7661

Specialties & licenses 2

Addresses

Other names 1

• Walmart Health Doing business as

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1184031163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160445",
            "telephone_number": "706-277-7661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 SHUGART RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202433",
            "telephone_number": "706-277-7661",
            "fax_number": "706-277-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MC MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-22",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A",
        "authorized_official_last_name": "PULLURU",
        "authorized_official_first_name": "SOUJANYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-277-7661"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walmart Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William S Mayberry, MD
• Linda J Mayes, LCSW
• Jan Renee Mayfield, MD
• Ginny Lee Mayher, SLP
• Thomas John Maytum Jr., PTA
• McAmis Anesthesia Consultants
• Alison McBride, NP
• Daniel James McBride, OD
• Rebecca McBride, OT/L
• Jessica Nicole McCabe, PT, DPT

• General Practice Physician in Dalton, GA
• Providers in Dalton, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.