Autumn Walton Mongo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1451 Highway 21 S Ste H
Springfield, GA 31329-5244

Phone

(912) 754-1035

Fax

(912) 754-1037

NPI assigned

Sep 2, 2020

Last updated

Nov 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Medical University of South Carolina College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Effingham Hospital IncGroup PAC ID 1254628092, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Effingham Health System Hospital, Springfield, GA, CCN 111306

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Effingham Hospital, Inc.

  dba Effingham Health System

  • Critical Access Hospital
  • Springfield, GA
  • NPI 1811962756
  Medicare reassignment Care Compare group NPD (past)
• Effingham Hospital, Inc.

  dba Effingham Ear Nose and Throat

  • Otolaryngology Physician
  • Springfield, GA
  • NPI 1881588028
  NPD
• Effingham Hospital, Inc.

  dba Effingham Family Medicine at Rincon

  • Rural Health Clinic/Center
  • Rincon, GA
  • NPI 1962806257
  NPD
• Onecare Clinic, LLC

  • Internal Medicine Physician
  • Hilton Head Island, SC
  • NPI 1639570799
  NPD (past)

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

• Effingham Hospital, Inc.

  dba Effingham Health System

  • Critical Access Hospital
  • Springfield, GA
  • NPI 1811962756
  Care Compare affiliation

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1427662964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 HIGHWAY 21 S STE H",
            "city": "SPRINGFIELD",
            "state": "GA",
            "postal_code": "313295244",
            "telephone_number": "912-754-1035",
            "fax_number": "912-754-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 HIGHWAY 21 S STE H",
            "city": "SPRINGFIELD",
            "state": "GA",
            "postal_code": "313295244",
            "telephone_number": "912-754-1035",
            "fax_number": "912-754-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGO",
        "first_name": "AUTUMN",
        "middle_name": "WALTON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-02",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McCabe Medical Group LLC
• Jamia McKelvin
• Shonda Miller, LAPC
• Brittany Mitchell, RN-BSN
• Mobile Medical Imaging of Coastal Georgia, LLC
• MPPG, Inc. (Springfield Medical Associates)
• MPPG, Inc. (Savannah Center for Respiratory, Critical Care, and Sleep Medicine)
• MPPG, Inc. (Surgical Specialists of Savannah)
• Madeline Neal
• Brenda Ned

• Physician Assistant in Springfield, GA
• Providers in Springfield, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.