Mlmcuc, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MLMCUC, LLC

Doing business as

Mountain Lakes Medical Group

Practice address

180 Legacy Point
Suite 201
Clayton, GA 30525

Phone

(706) 782-3100

NPI assigned

Aug 24, 2020

Last updated

Aug 18, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew Lemak

Title

Ceo

Phone

(205) 329-7501

Specialties & licenses 1

Addresses

Other names 1

• Mountain Lakes Medical Group Doing business as

Locations

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.

• Bryan Kelly McDonald, FNP-C

  • Family Nurse Practitioner
  • Clayton, GA
  • NPI 1164129128
  NPD (past)

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1972116630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 LEGACY PT",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "305255354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 LEGACY POINT",
            "address_2": "SUITE 201",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "30525",
            "telephone_number": "706-782-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLMCUC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-24",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "LEMAK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "205-329-7501"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Lakes Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountain Lakes Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medlink Georgia, Inc (MedLink Pharmacy - Rabun)
• Medlink Georgia, Inc
• Ashley D. Miller, OTR/L
• Autumn Mills, NP-C
• Mlmcuc, LLC (Mountain Lakes Medical Group)
• Lisa Mooney
• Harriet Josephine Moseley, LPN
• Sandra Joan Moss, LCSW
• Kyle Bennett Mott, RPH
• Mountain Laurel Medical Clinics, LLC

• Primary Care Clinic/Center in Clayton, GA
• Providers in Clayton, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.