Mana L Kasongo, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

057753 Issued in GA

Practice address

902 N 7TH St
Cordele, GA 31015-3270

Phone

(229) 276-3325

Fax

(229) 276-3322

NPI assigned

Jun 1, 2006

Last updated

Mar 5, 2021By the provider in NPPES

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 7

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Rush Medical College of Rush University, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoebe Worth Medical Center, IncGroup PAC ID 0840104527, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phoebe Home Health Home health agency, Albany, GA, CCN 117100
• Phoebe Worth Medical Center Hospital, Sylvester, GA, CCN 111328
• Phoebe Worth Medical Center Nursing home, CCN 11Z328

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Phoebe Worth Medical Center, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Sylvester, GA
  • NPI 1760460448
  Medicare reassignment Care Compare group NPD
• Chronic Disease Management of Georgia, LLC

  • Physical Medicine & Rehabilitation Physician
  • Monroe, GA
  • NPI 1699300939
  Medicare reassignment NPD
• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment NPD
• Phoebe Putney Memorial Hospital Inc

  dba Phoebe Putney Memorial Hosptial

  • General Acute Care Hospital
  • Albany, GA
  • NPI 1992789721
  Medicare reassignment NPD
• Phoebe Dorminy OB/GYN Associates

  • Clinic/Center
  • Fitzgerald, GA
  • NPI 1790066314
  NPD
• Phoebe Putney Memorial Hospital Inc

  dba Phoebe Specialty Pharmacy

  • Community/Retail Pharmacy
  • Albany, GA
  • NPI 1891315420
  NPD
• Phoebe Putney Memorial Hospital, Inc.

  dba Phoebe Family Medical Center - Pelham

  • Rural Health Clinic/Center
  • Pelham, GA
  • NPI 1821239765
  NPD
• Phoebe Worth Medical Center, Inc

  dba Phoebe Family Medicine

  • Rural Health Clinic/Center
  • Ashburn, GA
  • NPI 1144205014
  NPD
• Emergency Medicine South LLC

  • Emergency Medicine Physician
  • Valdosta, GA
  • NPI 1194785170
  NPD (past)
• Southwestern Emergency Physicians PC

  • Emergency Medicine Physician
  • Albany, GA
  • NPI 1356336986
  NPD (past)

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

• Phoebe Putney Memorial Hospital Inc

  dba Phoebe Home Health

  • Home Health Agency
  • Albany, GA
  • NPI 1790766863
  Care Compare affiliation
• Phoebe Worth Medical Center, Inc

  • Critical Access Hospital
  • Sylvester, GA
  • NPI 1639157431
  Care Compare affiliation
• Phoebe Worth Medical Center, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Sylvester, GA
  • NPI 1760460448

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1356388805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 N 7TH ST",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153270",
            "telephone_number": "229-276-3325",
            "fax_number": "229-276-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 N 7TH ST",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153270",
            "telephone_number": "229-276-3325",
            "fax_number": "229-276-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASONGO",
        "first_name": "MANA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "057753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "682562580C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "356927",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "682562580B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "682562580A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52202589-004",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00351740",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52202589",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamia Jones
• Terrikia Jonkoski, CNM
• Clifton Anthony Jordan, MASTER BARBER
• Randall W Jordan, OD
• Jyoti Karki, FNP
• David Kavtaradze, M.D.
• Kelley Granade Kichler, RD, LD, CNSD
• Kidney Clinic Cordele LLC
• Bianca Kierce, NP
• Emily Selph King, MS, RD, LD

• Emergency Medicine Physician in Cordele, GA
• Providers in Cordele, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.