Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

MS. Antoinette Theodore, PA-C

Individual provider Medical Physician Assistant · NPI 1558882381

MS. Antoinette Theodore, PA-C is a Physician Assistant in Peachtree Corners, Georgia. Qualified in 2017, 9 years ago. Practices with Personal Recovery Network LLC, a 605-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
9
Licensed in
GA
In the registry since
2017
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

5635 Peachtree Pkwy Ste 180
Peachtree Corners, GA 30092-2823
Phone: (470) 938-6670
Fax: (678) 272-3144
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 105 Iver Pl Apt 325, Fayetteville, GA 30214-4607 — (407) 361-2054

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 10250 (GA)

Record details

NPI number1558882381
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 1, 2017
Last updated in NPPESJanuary 26, 2022
Certification dateJanuary 26, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Personal Recovery Network Llc — 605 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare