Mercy B Manga, NP-C

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

RN100057 Issued in GA

Practice address

2400 Mt. Zion Parkway
Kaiser Permanente Southwood Medical Center
Jonesboro, GA 30236

Phone

(770) 603-3649

Fax

(770) 962-2400

NPI assigned

May 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7139/brand/1/csg/1/fhir/r4

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

• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956
  Medicare reassignment NPD
• Preferred Women'S Healthcare, LLC

  • Obstetrics Physician
  • Lawrenceville, GA
  • NPI 1245298017
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1104875525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT ROAD, NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30305",
            "telephone_number": "404-504-5678",
            "fax_number": "770-962-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MT. ZION PARKWAY",
            "address_2": "KAISER PERMANENTE SOUTHWOOD MEDICAL CENTER",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "30236",
            "telephone_number": "770-603-3649",
            "fax_number": "770-962-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGA",
        "first_name": "MERCY",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN100057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "433023341",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROV #",
            "identifier": "500030757",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "942031013A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Magnolia Counseling and Wellness
• Celestine O Maiki, MD
• Jerome A Maislis, PA-C
• Charles F Major Jr., D.M.D.
• Sylvester B Malcom, D.D.S.
• Azad Mansouri, MD
• Michelle Maples, RN
• Roland K Mapp
• Eddra Y Marchand, MD
• Marietta Healthcare

• Women's Health Nurse Practitioner in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Women's Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.