Edwidge Azor-Antoine

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

302190 Issued in GA

Practice address

626 Dallas Hwy
Villa Rica, GA 30180-1209

Phone

(770) 459-9378

NPI assigned

Oct 11, 2023

Last updated

Dec 3, 2025By the provider in NPPES

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Tanner Medical Group Inc

  • Cardiovascular Disease Physician
  • Carrollton, GA
  • NPI 1396979787
  NPD
• Westcare Villa Rica Pediatrics

  dba Westcare Pediatrics and Adult Medicine

  • Pediatrics Physician
  • Villa Rica, GA
  • NPI 1487742532
  NPD (past)

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

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1740061209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GREENWAY BLVD STE C",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174358",
            "telephone_number": "770-812-8825",
            "fax_number": "770-812-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 DALLAS HWY",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301801209",
            "telephone_number": "770-459-9378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZOR-ANTOINE",
        "first_name": "EDWIDGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-11",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "302190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Apollo Occupational Health LLC
• Kayla Michelle Arnold, LPC
• Arun K Kantamneni MD, Inc.
• Urooj Ather, MD
• Atrianon, LLC
• Elizabeth Grace Babcock, PT, DPT
• George W Bailey, M.D.
• Jennifer Bailey, PHYSICAL THERAPISTJE
• Erika Ballard
• Bankhead Chiropractic

• Pediatric Nurse Practitioner in Villa Rica, GA
• Providers in Villa Rica, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.