Individual provider Active NPI

Michael Oliver Kamanda, MD

  • Internal Medicine Physician
  • Marion, SC
National Provider Identifier
1780881185
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
31180 Issued in SC
Practice address
1115 N Main St
Marion, SC 29571-2025
Phone
(843) 423-0760
Fax
(843) 423-8138
NPI assigned
Jun 29, 2007
Last updated
Sep 8, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 31180 SC Primary

Addresses

Primary practice location

1115 N Main St
Marion, SC 29571-2025

Mailing address

1115 N Main St
Marion, SC 29571-2025
Phone (843) 423-0760

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101026001093 GA Practitioner - Internal Medicine 6103993464 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31180SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Hospitalists Group, LLC Current Accepting new patients
Southern Regional Physicians Management Group, LLC CurrentSince Feb 20, 2017 Accepting new patients
Georgia Hospitalists Group, LLC CurrentSince Jan 25, 2016 Accepting new patients
Covenant Medical Group LLC CurrentSince May 26, 2018 Accepting new patients
City of Hope Medical Group of Georgia LLC Internal Medicine CurrentSince Jan 9, 2013 Accepting new patients
Georgia Hospitalists Group, LLC CurrentSince Jan 25, 2016 Accepting new patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince Oct 1, 2015 Accepting new patients
Spalding Regional Physician Services, LLC Internal Medicine Past Accepting new patients
Regency Hospital Company of Macon LLC Past Accepting new patients

Locations

2360 Rockmart Hwy
Cedartown, GA 30125
Phone (770) 748-2500

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

11 Upper Riverdale Rd SW
Ste 21
Riverdale, GA 30274

483 Upper Riverdale Rd SW
Ste L
Riverdale, GA 30274
Phone (770) 742-3883

62742 Collections Ctr Dr
Chicago, IL 60693

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 9

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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1780881185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 N MAIN ST",
            "city": "MARION",
            "state": "SC",
            "postal_code": "295712025",
            "telephone_number": "843-423-0760",
            "fax_number": "843-423-8138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 N MAIN ST",
            "city": "MARION",
            "state": "SC",
            "postal_code": "295712025",
            "telephone_number": "843-423-0760",
            "fax_number": "843-423-8138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMANDA",
        "first_name": "MICHAEL",
        "middle_name": "OLIVER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "31180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, SC

Sources for this page

Verify at the official NPI Registry.