Individual provider Active NPI

Claudine Moma Malonga, DNP, C-PNP-PC

  • Pediatric Nurse Practitioner
  • Forest Park, GA
National Provider Identifier
1528869807
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN315619 Issued in GA
Practice address
4905 Courtney Dr
Forest Park, GA 30297-1427
Phone
(404) 366-3636
NPI assigned
Mar 21, 2025
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN315619 GA Primary

Addresses

Primary practice location

4905 Courtney Dr
Forest Park, GA 30297-1427

Mailing address

2216 Indian Hill Rd
Jonesboro, GA 30236-3949
Phone (770) 875-1739

Other names 1

  • Claudine Moma Kasongo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN315619GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Daffodil Pediatrics and Family Medicine Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1742515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1528869807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 INDIAN HILL RD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302363949",
            "telephone_number": "770-875-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 COURTNEY DR",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302971427",
            "telephone_number": "404-366-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONGA",
        "first_name": "CLAUDINE",
        "middle_name": "MOMA",
        "credential": "DNP, C-PNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-21",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN315619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLAUDINE",
            "last_name": "KASONGO",
            "middle_name": "MOMA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Forest Park, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.