Individual provider Active NPI

Angela Cudger, PA-A, HEALTH COACH

  • Health & Wellness Coach
  • Alpharetta, GA
National Provider Identifier
1720376833
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
Practice address
6820 Victory Run
Alpharetta, GA 30005-3002
Phone
(404) 388-7235
NPI assigned
Jul 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 1255 NC
Anesthesiologist Assistant 367H00000X 6865 GA
Health & Wellness Coach 171400000X GA Primary

Addresses

Primary practice location

6820 Victory Run
Alpharetta, GA 30005-3002

Mailing address

7778 McGinnis Ferry Road
PMB 303
Suwanee, GA 30024-2564
Phone (404) 388-7235

Other practice location 1

380 Hospital Dr
Suite 410
Macon, GA 31217
Phone (478) 746-5644

Other identifiers 5

IdentifierTypeStateIssuer
003135897AMedicaidGA
003135897CMedicaidGA
003135897BMedicaidGA
003135897DMedicaidGA
01869603OtherGAAMERIGROUP

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)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
6865GAMDNeonatal/Pediatric Registered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Holistic Health Institute Health & Wellness Coach CurrentSince Dec 10, 2023 Accepting new patients
Holisticare Staffng Solutions, LLC Health & Wellness Coach CurrentSince Dec 10, 2023 Accepting new patients

Locations

7778 McGinnis Ferry Rd
Suwanee, GA 30024
Phone (404) 944-1475

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1720376833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7778 MCGINNIS FERRY ROAD",
            "address_2": "PMB 303",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242564",
            "telephone_number": "404-388-7235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6820 VICTORY RUN",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053002",
            "telephone_number": "404-388-7235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 Hospital Dr",
            "address_2": "Suite 410",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "31217",
            "country_code": "US",
            "telephone_number": "478-746-5644",
            "fax_number": "478-745-4849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUDGER",
        "first_name": "ANGELA",
        "name_prefix": "Mrs.",
        "credential": "PA-A, HEALTH COACH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "NC",
            "license": "1255",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "6865",
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003135897A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003135897C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003135897B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003135897D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01869603",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.