Antonia Lanette Green-Fuqua, CRNP

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

1-100637 Issued in AL

Practice address

17157 Huntsville Brownsferry Rd
Athens, AL 35611-6014

Phone

(256) 348-1382

NPI assigned

Sep 20, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: antonia.green-fuqua.1@23004.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1164249249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17157 HUNTSVILLE BROWNSFERRY RD",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356116014",
            "telephone_number": "256-348-1382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17157 HUNTSVILLE BROWNSFERRY RD",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356116014",
            "telephone_number": "256-348-1382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN-FUQUA",
        "first_name": "ANTONIA",
        "middle_name": "LANETTE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AL",
            "license": "1-100637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Gossett, C.R.N.P.
• Doyle Wayne Graham, CRNA
• Mary Katherine Graham
• William Grant III
• Melissa C Gray, M.D.
• Wendy Lynn Green, C.R.N.P
• Gregg P. Moody, PC
• Eli Eugene Griffin, CRNP
• Henry Gilman Griggs Jr., D.M.D.
• Henry Gilman Griggs, D.M.D.

• General Practice Physician in Athens, AL
• Providers in Athens, AL by specialty
• General Practice Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.