Individual provider Active NPI

Antoinette Peta-Gay Lee-Gregory, CNM

  • Advanced Practice Midwife
  • Fort Moore, GA
National Provider Identifier
1891073763
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
APRN-CNM185722 Issued in GA
Practice address
6600 Van Aalst Blvd
Fort Moore, GA 31905-2102
Phone
(762) 408-0493
NPI assigned
Jul 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X APRN-CNM185722 GA Primary

Addresses

Primary practice location

6600 Van Aalst Blvd
Fort Moore, GA 31905-2102

Mailing address

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-3294

Other practice location 1

710 Center St
Columbus, GA 31901-1527
Phone (706) 571-1000

Other practice location 2

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-3294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120626000639 GA Practitioner - Certified Nurse Midwife (CNM) 9133384001 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHP of Piedmont PCGroup PAC ID 9133378763, 18 clinicians

Practice addresses (Care Compare)

710 Ctr St
Columbus, GA 31901-1527
Phone (706) 571-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
DHP of Piedmont PC CurrentSince Oct 1, 2020 Accepting new patients
The Emory Clinic Inc CurrentSince Oct 26, 2018 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Southside Medical Center, Inc. CurrentSince May 16, 2012 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Nov 1, 2025 Accepting new patients
Southside Medical Center, Inc CurrentSince May 16, 2012 Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

Locations

1046 Ridge Ave SW
Atlanta, GA 30315
Phone (404) 564-6942

1039 Ridge Ave SW
Atlanta, GA 30315
Phone (407) 761-8640

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435

Organizations & group practices 8

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": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1891073763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467694",
            "telephone_number": "678-312-3294",
            "fax_number": "678-312-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "762-408-0493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 Center St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319011527",
            "country_code": "US",
            "telephone_number": "706-571-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300467694",
            "country_code": "US",
            "telephone_number": "678-312-3294",
            "fax_number": "678-312-3282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE-GREGORY",
        "first_name": "ANTOINETTE",
        "middle_name": "PETA-GAY",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-26",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "APRN-CNM185722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Moore, GA

Sources for this page

Verify at the official NPI Registry.