Organization Active NPI

Harkemac, LLC

Doing business as Moundville Primary Care Associates

  • Family Medicine Physician
  • Moundville, AL
National Provider Identifier
1861174880
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HARKEMAC, LLC
Doing business as
Moundville Primary Care Associates
Practice address
16063 Highway 69 S
Moundville, AL 35474-6209
Phone
(205) 371-2267
Fax
(205) 371-2901
NPI assigned
Aug 1, 2023
Last updated
Jan 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Authorized official

Name
Nicole Jones
Title
Billing Manager
Phone
(205) 710-6129

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

16063 Highway 69 S
Moundville, AL 35474-6209

Mailing address

PO Box 687
Moundville, AL 35474-0687
Phone (205) 371-2267

Other names 1

  • Moundville Primary Care Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230907003586 AL Part B Supplier - Clinic/Group Practice 4284098302 Receives reassigned benefits from 2 practitioners
Practice locations: Moundville, 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
01D2287443Moundville Primary Care Associates16063 Highway 69 South, Moundville, AL 35474Provider-performed microscopyAug 14, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1690848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1861174880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 687",
            "city": "MOUNDVILLE",
            "state": "AL",
            "postal_code": "354740687",
            "telephone_number": "205-371-2267",
            "fax_number": "205-371-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16063 HIGHWAY 69 S",
            "city": "MOUNDVILLE",
            "state": "AL",
            "postal_code": "354746209",
            "telephone_number": "205-371-2267",
            "fax_number": "205-371-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARKEMAC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-01",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "205-710-6129"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moundville Primary Care Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moundville Primary Care Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moundville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.