Fanta Elizabeth Kasiah, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4212 Issued in GA

Practice address

104 N Belair Rd
Suite 101
Evans, GA 30809-6503

Phone

(706) 922-3669

NPI assigned

Jun 24, 2010

Last updated

Oct 3, 2014By 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

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 MedicineAlso: Family Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southland Burke Emergency Medical Services, LLCGroup PAC ID 9537547401, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University McDuffie County Regional Medical Center Hospital, Thomson, GA, CCN 110111
• Piedmont Augusta Hospital Hospital, Augusta, GA, CCN 110028
• Burke Medical Center Hospital, Waynesboro, GA, CCN 110113

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.

• Southland Burke Emergency Medical Services, LLC

  • Emergency Medicine Physician
  • Waynesboro, GA
  • NPI 1235885815
  Medicare reassignment Care Compare group NPD
• Au Medical Associates Inc

  • Multi-Specialty Clinic/Center
  • Augusta, GA
  • NPI 1841230620
  Medicare reassignment NPD
• Med Now Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Evans, GA
  • NPI 1245475771

  Family Medicine

  Medicare reassignment NPD
• Peach State Emergency Physicians LLC

  • Emergency Medicine Physician
  • Augusta, GA
  • NPI 1053170605
  Medicare reassignment NPD
• Physicians United Urgent Care

  • Urgent Care Clinic/Center
  • Augusta, GA
  • NPI 1497313258
  Medicare reassignment NPD
• Southland Emergency Medical Services Consolidated, LLC

  • Hospitalist Physician
  • Cochran, GA
  • NPI 1033464391

  Family Medicine

  Medicare reassignment NPD
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555

  GA

  Medicare reassignment NPD
• Au Medical Associates Inc

  dba Augusta University Health West Wheeler

  • Durable Medical Equipment & Medical Supplies
  • Augusta, GA
  • NPI 1114574126
  NPD
• Emanuel County Hospital Authority

  dba Emanuel Surgical Associates

  • Surgery Physician
  • Swainsboro, GA
  • NPI 1003221243
  NPD
• Screven County Family Health Center, LLC

  dba Optim Primary Care - Sylvania

  • Rural Health Clinic/Center
  • Sylvania, GA
  • NPI 1841432044

  Family Medicine

  NPD (past)

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

• Burke Hospital Company

  dba Burke Health

  • General Acute Care Hospital
  • Waynesboro, GA
  • NPI 1730761065
  Care Compare affiliation
• University Health Services,Inc

  dba Piedmont Augusta Hospital

  • General Acute Care Hospital
  • Augusta, GA
  • NPI 1588665566
  Care Compare affiliation
• University McDuffie County Regional Medical Center, Inc.

  dba Piedmont McDuffie Hospital

  • General Acute Care Hospital
  • Thomson, GA
  • NPI 1982600540
  Care Compare affiliation

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1639480684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 N BELAIR RD",
            "address_2": "SUITE 101",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308096503",
            "telephone_number": "706-922-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N BELAIR RD",
            "address_2": "SUITE 101",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308096503",
            "telephone_number": "706-922-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASIAH",
        "first_name": "FANTA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-24",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "4212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justen Judge
• Kevin M Kaiser
• Emily Kale, DPT
• Kathy B Kallmann, LPC
• Clint Karamath Jr., DC
• Srinivasa Venkata Siva Kumar Kasina, MBBS
• Teru Kassner
• Katie Nelson, LPC, LLC
• Lakeshia Mae Kauffman, ABOC, NCLEC, LDO
• Poonaminder Kaur, MD

• Family Medicine Physician in Evans, GA
• Providers in Evans, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.