Active NPI
Kasonya Guerra, MD
- Neonatal-Perinatal Medicine Physician
- Greenwood, SC
National Provider Identifier
1174891931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 40525
- Practice address
- 1325 Spring St
Greenwood, SC 29646-3860 - Phone
- (864) 725-4449
- Fax
- (864) 725-4452
- NPI assigned
- Dec 8, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 40525 | SC | Primary |
Addresses
Primary practice location
1325 Spring St
Greenwood, SC 29646-3860
Mailing address
1325 Spring Street
Greenwood, SC 29646-3860
Phone (864) 725-4449
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kguerra187926@selfregional.direct-ci.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40525 | SC | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Self Medical Group | Current | Accepting new patients | |
| Self Medical Group | Current | Accepting new patients | |
| Self Medical Group | Current | Accepting new patients | |
| Self Medical Group | Past | Accepting new patients | |
| Self Regional Healthcare | Past | Accepting new patients |
Locations
75 Remittance Dr
Dept 6764
Chicago, IL 60675
1325 Spring St
Greenwood, SC 29646
Phone (864) 227-4111
2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866
Interoperability endpoints
- kguerra85888@direct.anmedhealth.net
Organizations & group practices 5
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.
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- NPI 1659839694
-
- Gastroenterology Physician
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- NPI 1841047560
-
- General Acute Care Hospital
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1174891931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1325 SPRING STREET",
"city": "GREENWOOD",
"state": "SC",
"postal_code": "296463860",
"telephone_number": "864-725-4449",
"fax_number": "864-725-4452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 SPRING ST",
"city": "GREENWOOD",
"state": "SC",
"postal_code": "296463860",
"telephone_number": "864-725-4449",
"fax_number": "864-725-4452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUERRA",
"first_name": "KASONYA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-08",
"last_updated": "2022-07-21",
"certification_date": "2021-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "SC",
"license": "40525",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kguerra187926@selfregional.direct-ci.net",
"affiliation": "N",
"address_1": "1325 Spring St",
"city": "Greenwood",
"state": "SC",
"country_code": "US",
"postal_code": "296463860",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Greenwood, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.