Individual provider Active NPI

Angel Mawuena Fugar, CPNP-PC

  • Pediatric Nurse Practitioner
  • Loganville, GA
National Provider Identifier
1154246734
Registry record updated Nov 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN-NP313168 Issued in GA
Practice address
297 Cooper Rd
Loganville, GA 30052-2518
Phone
(678) 381-2630
NPI assigned
Aug 12, 2026
Last updated
Nov 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN-NP313168 GA Primary

Addresses

Primary practice location

297 Cooper Rd
Loganville, GA 30052-2518

Mailing address

297 Cooper Rd
Loganville, GA 30052-2518
Phone (678) 381-2630

Other practice location 1

80 Parker Dr
Monroe, GA 30656-1100
Phone (678) 381-2630

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address angel.fugar.1@28046.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
APRN-NP313168GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grayson Pediatrics, LLC Pediatrics Past Accepting new patients
Grayson Pediatrics, LLC Pediatrics PastSince Apr 21, 2024 Accepting new patients

Organizations & group practices 2

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": "1786492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793836800000",
    "number": "1154246734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 COOPER RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522518",
            "telephone_number": "678-381-2630",
            "fax_number": "678-381-2627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 COOPER RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522518",
            "telephone_number": "678-381-2630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Parker Dr",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "GA",
            "postal_code": "306561100",
            "country_code": "US",
            "telephone_number": "678-381-2630",
            "fax_number": "678-381-2627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUGAR",
        "first_name": "ANGEL",
        "middle_name": "MAWUENA",
        "name_prefix": "Ms.",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-12",
        "last_updated": "2026-11-05",
        "certification_date": "2026-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "APRN-NP313168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "angel.fugar.1@28046.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "297 Cooper Rd",
            "city": "Loganville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300522518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.