MRS. MERCY B MANGA (NPI# 1104875525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104875525 |
| Entity Type | Individual |
| Full Name | MRS. MERCY B MANGA |
| Credential | NP-C |
| Practice Address |
2400 Mt. Zion Parkway Kaiser Permanente Southwood Medical Center Jonesboro GA 30236 |
| Mailing Address |
3495 Piedmont Road, Ne Nine Piedmont Center Atlanta GA 30305 |
| Practice Telephone | 7706033649 |
| Practice Fax Number | 7709622400 |
| Mailing Telephone | 4045045678 |
| Mailing Fax Number | 7709622400 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2016-05-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
RN100057 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | RAILROAD MEDICARE PROV # | 500030757 | 01 |
| GA | 942031013A | 05 | |
| GA | TRICARE | 433023341 | 01 |
| Street Address |
2400 MT. ZION PARKWAY KAISER PERMANENTE SOUTHWOOD MEDICAL CENTER |
| City | JONESBORO |
| State | GA |
| Zip Code | 30236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508866153 | Jodi Bayley Baptiste | Family Medicine | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236 | 2005-07-26 |
| 1013450816 | Dorothy Delisfort-crisostomo | Nurse Practitioner | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehension Medical Offic, Jonesboro, GA 30236 | 2016-11-28 |
| 1639590136 | Ashley Christine Ziobrowski | Nurse Practitioner | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236 | 2013-12-31 |
| 1730520321 | Nash Ditmetaroj | Optometrist | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236 | 2013-07-10 |
| 1770927402 | Labrittany R Davis-farve | Nurse Practitioner | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2013-04-24 |
| 1477896645 | Fofie S Akoto | Internal Medicine | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2013-04-05 |
| 1265773584 | Karen Kelly Willard | Nurse Practitioner | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2013-03-12 |
| 1114264652 | Jaclyn Marie Schwartz | Podiatrist | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2013-01-03 |
| 1801144605 | Dorie Angela Saxon | Pediatrics | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2012-08-28 |
| 1689937880 | Meena Yasmeen | Family Medicine | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2012-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123362 | Life Source Counseling & Consulting, LLC | Clinic/Center | 118 North Avenue, Suite A, Jonesboro, GA 30236 | 2020-04-25 |
| 1639609555 | New Beginnings Behavioral Counseling,llc | Social Worker | 9456 S Main St Ste E2, Jonesboro, GA 30236 | 2017-06-13 |
| 1437696762 | Clarissa Alexandra Poole | Counselor | 2106 Fair Ridge Ct, Jonesboro, GA 30236 | 2017-01-25 |
| 1588012892 | Sundance Healthcare Service Inc | In Home Supportive Care | 7861 Collinswood Court, Jonesboro, GA 30236 | 2016-05-26 |
| 1942669205 | Adrianne Smiley Gurley | Occupational Therapist | 1299 Battlecreek Rd Ste 210, Jonesboro, GA 30236 | 2016-02-15 |
| 1336505809 | Integrated Health Center | Dentist | 8600 Tara Blvd, Suite D, Jonesboro, GA 30236 | 2016-01-13 |
| 1467827402 | Surrell Porter | Nurse Practitioner | 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 | 2015-12-02 |
| 1740688910 | Jacqueline Carolyn Edwards | Registered Nurse | 8081 Tara Blvd, 265, Jonesboro, GA 30236 | 2014-12-19 |
| 1770991861 | Lower Extremity Diagnostics, LLC | Podiatrist | 6911 Tara Boulevard, Jonesboro, GA 30236 | 2014-08-01 |
| 1760899710 | Fresenius Medical Care Jonesboro, LLC | Clinic/Center | 8060 Summitt Business Parkway, Jonesboro, GA 30236 | 2014-07-22 |
| Find all providers in zip 30236 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316225881 | Marlynn B Jones | Nurse Practitioner | 1117 Battlecreek Rd, Jonesboro, GA 30236-2407 | 2011-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497368328 | Jennifer Cobb | Nurse Practitioner | 130 Champlain St, Decatur, GA 30030-1803 | 2020-08-29 |
| 1336766476 | Nadine L Donahue | Nurse Practitioner | 1703 Oglethorpe Dr Ne, Brookhaven, GA 30319-2791 | 2020-07-05 |
| 1003465337 | Kaitlin Wilson | Nurse Practitioner | 5195 Jimmy Carter Blvd, Norcross, GA 30093-1649 | 2019-09-09 |
| 1912555939 | Erika Parks | Nurse Practitioner | 81 Upper Riverdale Rd Sw Ste 210, Riverdale, GA 30274-2627 | 2019-09-03 |
| 1427600469 | Kytrena L Harris | Nurse Practitioner | 232 Seaton Ave, Grovetown, GA 30813-4259 | 2019-07-10 |
| 1720640162 | Sonya Coutee Wallace | Nurse Practitioner | 3200 Highlands Pkwy Se Ste 420, Smyrna, GA 30082-5192 | 2019-07-06 |
| 1134783152 | Julia Coleman Quinn | Nurse Practitioner | 220 Cobb Pkwy N Ste 500, Marietta, GA 30062-3580 | 2019-04-24 |
| 1144782749 | Keely Darnell | Nurse Practitioner | 133 Samaritan Dr Ste 306, Cumming, GA 30040-2396 | 2019-04-02 |
| 1578020103 | Stacey Leigh Newpher | Nurse Practitioner | 960 Johnson Fy Rd Ne Ste 130, Atlanta, GA 30342-1601 | 2019-03-01 |
| 1144702226 | Veneah Shante Hall | Nurse Practitioner | 440 Moreland Ave Se, Atlanta, GA 30316-1926 | 2018-09-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.