PROVIDENCE OBGYN LLC
NPI 1124750369
Obstetrics & Gynecology in Dublin, GA
NPI Status: Active since June 27, 2022
Contact Information
206 FAIRVIEW PARK DR
DUBLIN, GA
ZIP 31021
Phone: (478) 246-4304
Fax: (478) 246-4282
- Organization
- Obstetrics & Gynecology
- Accepts Insurance
- CLIA Number: 11D2266575
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-11-2026
About PROVIDENCE OBGYN LLC
This page provides the complete NPI Profile along with additional information for Providence Obgyn Llc, a women's health care provider established in Dublin, Georgia operating as a Obstetrics & Gynecology. The healthcare provider is registered in the NPI registry with number 1124750369 assigned on June 2022. The practitioner's primary taxonomy code is 207V00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Lauri Bullen Md (Sole Partner)
- NPI
- 1124750369
- Provider Name
- PROVIDENCE OBGYN LLC
- Entity Type
- Organization
- Location Address
- 206 FAIRVIEW PARK DR DUBLIN, GA 31021
- Location Phone
- (478) 246-4304
- Location Fax
- (478) 246-4282
- Mailing Address
- 206 FAIRVIEW PARK DR DUBLIN, GA 31021
- Mailing Phone
- (478) 246-4304
- Mailing Fax
- (478) 246-4282
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-27-2022
- Last Update Date
- 11-17-2025
- Code Navigator
Women's health care providers like Providence Obgyn Llc treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.
Location Map
Secondary Locations
- 227 Industrial Blvd
Dublin, GA 31021
(478) 246-4304
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Obstetrics & Gynecology
- Taxonomy Code
- 207V00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- SoloCare Bronze EPO $8500 DED HSA 10004 - EPO
- SoloCare Exp Bronze EPO $9500 DED 10015 - EPO
- SoloCare Gold EPO $1500 DED 10010 - EPO
- SoloCare Silver EPO $5000 DED 10014 - EPO
- SoloCare Silver EPO $6500 DED 10013 - EPO
- SoloCare Standard Exp Bronze EPO $7500 DED 10008 - EPO
- SoloCare Standard Gold EPO $2000 DED 10006 - EPO
- SoloCare Standard Platinum EPO $0 DED 10005 - EPO
- SoloCare Standard Silver EPO $6000 DED 10007 - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D2266575
- Facility Type
- Physician Office
- Certificate Effective Date
- August 12, 2024
- Certificate Expiration Date
- August 11, 2026
- Laboratory Director
- LAURI W. BULLEN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Providence Obgyn Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1124750369, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 51 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124750369, enumerated as an "organization" on June 27, 2022.
The provider is located at 206 FAIRVIEW PARK DR DUBLIN, GA 31021 and the phone number is (478) 246-4304.
Obstetrics & Gynecology with taxonomy code 207V00000X.
The provider might be accepting Accepts: Alliant Health Plans, Inc.. Please consult your insurance carrier or call the provider to verify.
