Individual provider Active NPI

Gladys Grace Tiwonge Kamanga-Sollo, MD

  • Physical Medicine & Rehabilitation Physician
  • Cape Girardeau, MO
National Provider Identifier
1003115536
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2015011346 Issued in MO
Practice address
1723 Broadway St
Suite 410
Cape Girardeau, MO 63701-4566
Phone
(573) 332-7746
Fax
(573) 339-9709
NPI assigned
Mar 23, 2011
Last updated
Jan 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 2015011346 MO Primary

Addresses

Primary practice location

1723 Broadway St
Suite 410
Cape Girardeau, MO 63701-4566

Mailing address

1723 Broadway St
Suite 410
Cape Girardeau, MO 63701-4566
Phone (573) 332-7746

Other practice location 1

1117 Maple St
Farmington, MO 63640-7640
Phone (573) 332-7746

Other identifiers 1

IdentifierTypeStateIssuer
2015011346OtherMOMO STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150507000873 MO Practitioner - Physical Medicine and Rehabilitation 6103145420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
George Washington University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Facilities Rehab Services IncGroup PAC ID 3476679226, 152 clinicians
Regional Brain and Spine LLCGroup PAC ID 0749237808, 11 clinicians

Practice addresses (Care Compare)

1102 Sikes Ave
Sikeston, MO 63801-5021

1723 Broadway St
Suite 410
Cape Girardeau, MO 63701-4556
Phone (573) 332-7746

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.47 of 100Reported as individual
Quality
87.29
Promoting interoperability
91
Improvement activities
40
Cost
68.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2015011346MOMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Brain & Spine LLC CurrentSince Jun 30, 2015 Accepting new patients
Regional Brain & Spine LLC CurrentSince Jun 30, 2015 Accepting new patients

Locations

1723 Broadway St
Ste 410
Cpe Girardeau, MO 63701
Phone 5733327746106

1117 Maple St
Farmington, MO 63640
Phone (537) 332-7746

Networks

  • IL PPO Downstate
  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
  • IA HMO C-SNP
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • IA HMO

Interoperability endpoints

  • Direct secure messaging: gladys.grace.kamanga-sollo.1@23947.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/23947/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1003115536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 BROADWAY ST",
            "address_2": "SUITE 410",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014566",
            "telephone_number": "573-332-7746",
            "fax_number": "573-339-9709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 BROADWAY ST",
            "address_2": "SUITE 410",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014566",
            "telephone_number": "573-332-7746",
            "fax_number": "573-339-9709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1117 Maple St",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "MO",
            "postal_code": "636407640",
            "country_code": "US",
            "telephone_number": "573-332-7746",
            "fax_number": "573-339-9709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMANGA-SOLLO",
        "first_name": "GLADYS GRACE",
        "middle_name": "TIWONGE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-23",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2015011346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO STATE LICENSE",
            "identifier": "2015011346",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.