Organization Active NPI

MMC, M.D., LLC

  • Family Medicine Physician
  • Northport, AL
National Provider Identifier
1316559917
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MMC, M.D., LLC
Practice address
3509 Watermelon Rd
Northport, AL 35473-5174
Phone
(205) 366-0221
Fax
(205) 366-0342
NPI assigned
Aug 17, 2020
Last updated
Feb 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Authorized official

Name
Michelle Hawthorne, MS
Title
Billing Manager
Phone
(205) 997-2417

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

3509 Watermelon Rd
Northport, AL 35473-5174

Mailing address

3509 Watermelon Rd
Northport, AL 35473-5174
Phone (205) 366-0221

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200921001964 AL Part B Supplier - Clinic/Group Practice 5698193886 Receives reassigned benefits from 1 practitioner
Practice locations: Northport, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770595200000",
    "number": "1316559917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 WATERMELON RD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735174",
            "telephone_number": "205-366-0221",
            "fax_number": "205-366-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 WATERMELON RD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735174",
            "telephone_number": "205-366-0221",
            "fax_number": "205-366-0342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMC, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-17",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A",
        "authorized_official_last_name": "HAWTHORNE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "205-997-2417",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.