# CHRONIC DISEASE MANAGEMENT OF GEORGIA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699300939
- **Authorized official:** DR. VAMSI KANAGALA MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (803) 587-5163

## Contact information

- **Practice address:** 704 BREEDLOVE DR STE A, MONROE, GA 30655-2054
- **Practice address phone:** (888) 772-0076
- **Practice address fax:** (770) 751-8014
- **Mailing address:** PO BOX 604169, CHARLOTTE, NC 28260-4169
- **Mailing address phone:** (888) 772-0076
- **Mailing address fax:** (803) 587-5911

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | — |
| 207RH0002X | Hospice and Palliative Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RH0002X | Hospice and Palliative Medicine (Internal Medicine) Physician | — | — | — |
| 207RI0200X | Infectious Disease Physician | — | NULL | — |
| 207RI0200X | Infectious Disease Physician | — | — | — |
| 207RN0300X | Nephrology Physician | — | NULL | — |
| 207RN0300X | Nephrology Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 2081H0002X | Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081H0002X | Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 2081N0008X | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081N0008X | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 2081P0004X | Spinal Cord Injury Medicine Physician | — | NULL | — |
| 2081P0004X | Spinal Cord Injury Medicine Physician | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | NULL | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 03/06/2020
- **Last updated:** 12/02/2025