Individual provider Active NPI

Antonia Dixon Autry

  • Registered Nurse
  • Augusta, GA
National Provider Identifier
1245598341
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN049791 Issued in GA
Practice address
1350 Walton Way
Augusta, GA 30901-2612
Phone
(706) 774-8841
NPI assigned
Apr 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN049791 GA Primary

Addresses

Primary practice location

1350 Walton Way
Augusta, GA 30901-2612

Mailing address

3215 Bel Ridge Rd
Augusta, GA 30909-9635
Phone (706) 868-0734

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
RN049791GAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1245598341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 BEL RIDGE RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309099635",
            "telephone_number": "706-868-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012612",
            "telephone_number": "706-774-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUTRY",
        "first_name": "ANTONIA",
        "middle_name": "DIXON",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-26",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN049791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.