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MACON MEDICAL CLINIC, LLC.
NPI 1063823482
Clinic/Center - Primary Care in Macon, GA

Active since May 20, 2014CLIA 11D0976454 · Waiver
3350 NORTHSIDE DR, MACON, GA 31210(478) 405-2121(478) 405-0114 Get Directions Write a Review

NPPES record last updated: May 20, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Macon Medical Clinic, Llc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MACON MEDICAL CLINIC, LLC. (NPI 1063823482) is a healthcare organization registered as a primary care in Macon, Georgia and active in the NPI registry since May 2014. The organization holds a CLIA Waiver certificate valid through August 3, 2026 and lists Mohammad Mohabubur Rahman, Provider/physician/owner, as its authorized official.

NPPES Registry Identity

NPI1063823482
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameMACON MEDICAL CLINIC, LLC.
Location Address3350 NORTHSIDE DRMacon, GA 31210-2504
Mailing Address3350 Northside DrMacon, GA 31210-2504 · (478) 405-2121 · Fax (478) 405-0114
Phone(478) 405-2121
Fax(478) 405-0114
Organization SubpartNo
Authorized OfficialMohammad Mohabubur RahmanProvider/physician/owner · (478) 405-2121
Enumeration DateMay 20, 2014
✔ NPI 1063823482 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in GA · 044065
Also ListedClinic/Center · Health ServiceTaxonomy 261QH0100X · License 044065 (GA)
Also ListedClinic/Center · Medical SpecialtyTaxonomy 261QM2500X · License 044065 (GA)
3350 NORTHSIDE DR, Macon, GA 31210
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D0976454

Macon Medcial Clinic, LLC · Macon, GA
Active · expires Aug 3, 2026
CLIA Number11D0976454
Laboratory TypePhysician Office
Certificate Effective DateAugust 4, 2024
Certificate Expiration DateAugust 3, 2026
Laboratory DirectorMohammad M. Rahman MD
Laboratory Phone(478) 405-2121
Laboratory LocationMacon Medcial Clinic, LLC3350 Northside Drive, Macon, GA 31210
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MOHAMMAD MOHABUBUR RAHMAN MD
Internal Medicine
3350 NORTHSIDE DR
MACON, GA 31210
Bibb County (478) 405-2121

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Macon Medical Clinic, LLC.'s NPI number?

The NPI number for Macon Medical Clinic, LLC. is 1063823482. It was assigned to this organization in the NPPES registry on May 20, 2014.

Where is Macon Medical Clinic, LLC. located?

Macon Medical Clinic, LLC. is located at 3350 Northside Dr, Macon, GA 31210. The listed phone number is (478) 405-2121.

What is Macon Medical Clinic, LLC.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Macon Medical Clinic, LLC. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0976454) is associated with this NPI, valid through August 3, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Macon Medical Clinic, LLC. accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Macon Medical Clinic, LLC. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Macon Medical Clinic, LLC. was last updated on May 20, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.