Alexis Antoniolli, NP
Individual provider Active NPI Nurse Practitioner · Peachtree City, GA
NPI 1053264408 · NPPES record last updated Jun 11, 2026
Key facts
- NPI
- 1053264408
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APRN-NP210580 (GA)
- Practice address
- 1975 Highway 54 W Ste 150
Peachtree City, GA 30269-4795 - Phone
- (770) 486-5000
- NPI assigned
- Feb 17, 2026
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN210580 | GA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Piedmont Medical Care Corporation | Past | Accepting new patients | |
| Piedmont Providers LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN-NP210580 | GA | Yes |
| Registered Nurse | 163W00000X | RN210580 | GA |
Addresses
Primary practice location
1975 Highway 54 W Ste 150
Peachtree City, GA 30269-4795
Mailing address
125 Cornwall BRG
Peachtree Cty, GA 30269-1380
Phone (404) 664-6340
Other practice location 1
125 Cornwall Brg
Peachtree Cty, GA 30269-1380
Phone (404) 664-6340
Other providers in Peachtree City, GA
- Anesthesia Plus LLC
- Angel Pain Relief Center
- Paula Andrea Angulo
- Ankle and Foot Centers of Georgia, LLC
- Brianna Anthony
- Ruby Appiah
- Wendy Hunt Archibald
- Arise Recovery Residences
- Mahogany Arnold
- Michael Arnold
All providers in Peachtree City, GA · Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.