NPIMap

Organization Active NPI

M Medical Group SE LLC

  • Internal Medicine Physician
  • Athens, TX
National Provider Identifier
1609530013
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
M MEDICAL GROUP SE LLC
Practice address
121 Commons Dr
Athens, TX 75751-0009
Phone
(903) 677-3434
NPI assigned
Oct 22, 2021
Last updated
Jun 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Authorized official

Name
Melissa Reep
Title
Billing Manager
Phone
(888) 307-2425

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X

Addresses

Primary practice location

121 Commons Dr
Athens, TX 75751-0009

Mailing address

6 E Eager St
Baltimore, MD 21202-2506
Phone (888) 307-2425

Other practice location 1

1704 Huntington Village Cir
Daytona Beach, FL 32114-1484
Phone (386) 255-6571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220209001431 FL Part B Supplier - Clinic/Group Practice 4385037670 Receives reassigned benefits from 17 practitioners
Practice locations: Daytona Beach, FL; St Augustine, FL; South Daytona, FL; Port Orange, FL; Ormond Beach, FL; Holly Hill, FL; Deltona, FL; Deland, FL…
O20221216001760 TX Part B Supplier - Clinic/Group Practice 4385037670 Receives reassigned benefits from 4 practitioners
Practice locations: Wills Point, TX; White Settlement, TX; Sulphur Springs, TX; Rockwall, TX; Mesquite, TX; Kilgore, TX; Greenville, TX; Crockett, TX…

National Provider Directory

National Provider Directory

Locations

550 National Health Care Dr
#D
Daytona Beach, FL 32114
Phone (386) 257-6362

120 W Chipola Ave
Deland, FL 32720
Phone (386) 738-3433

1200 N Stone St
Deland, FL 32720
Phone (317) 686-6639

900 Lpga Blvd
Holly Hill, FL 32117
Phone (386) 226-9000

1901 Whipporwill Ln
Kilgore, TX 75662
Phone (903) 278-8276

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780963200000",
    "number": "1609530013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 E EAGER ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022506",
            "telephone_number": "888-307-2425",
            "fax_number": "412-729-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 COMMONS DR",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757510009",
            "telephone_number": "903-677-3434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1704 Huntington Village Cir",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321141484",
            "country_code": "US",
            "telephone_number": "386-255-6571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "M MEDICAL GROUP SE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-22",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A",
        "authorized_official_last_name": "REEP",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "888-307-2425"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.