RAEONDA BULLARD MD
NPI 1144713652
Obstetrics & Gynecology in Douglasville, GA

Q: What is Raeonda Bullard's NPI number?

The NPI number for Raeonda Bullard is 1144713652. It was assigned to this individual provider in the NPPES registry on June 8, 2018. The provider is also known as Raeonda Williams MD.

Q: What is Raeonda Bullard's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Q: When was this NPI record last updated?

The NPPES record for Raeonda Bullard was last updated on September 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 08, 2018PECOS Enrolled

6095 PROFESSIONAL PKWY STE A210, DOUGLASVILLE, GA 30134(770) 949-4188(770) 949-1614 Get Directions Write a Review

NPPES record last updated: September 26, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 26, 2024, Sep 16, 2022 (2 updates tracked since 2022).

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About Raeonda Bullard Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAEONDA BULLARD MD (NPI 1144713652) is an individual obstetrics & gynecology provider in Douglasville, Georgia, licensed in Georgia (93170) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS and maintains a secondary practice location in Dunwoody.

NPPES Registry Identity

NPI1144713652

Entity TypeIndividualFemale

Primary Taxonomy207V00000X

Provider Legal NameRAEONDA BULLARDCredential: MD

Location Address6095 PROFESSIONAL PKWY STE A210Douglasville, GA 30134-5611

Mailing Address6095 Professional Pkwy Ste A210Douglasville, GA 30134-5611 · (770) 949-4188 · Fax (770) 949-1614

Phone(770) 949-4188

Fax(770) 949-1614

Sole ProprietorNo

Enumeration DateJune 8, 2018

Last NPPES UpdateSeptember 26, 20242 updates tracked since enumeration

NPPES CertifiedSeptember 26, 2024

✔ NPI 1144713652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

Licenses✔ Licensed in GA · 93170✔ Licensed in GA · 010079

Definition

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.

6095 PROFESSIONAL PKWY STE A210, Douglasville, GA 30134

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Other Names 1

Former Name (1)Raeonda Williams Md

Secondary Practice Location 1

Location 12029 Pernoshal CtDunwoody, GA 30338-6405 · Phone (770) 730-0451 · Fax (770) 730-0141

Other Identifiers 1

Medicaid300034164AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Raeonda Bullard Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Raeonda Bullard reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wellstar Medical Group, LLC

Same address

Obstetrics & Gynecology

6095 PROFESSIONAL PKWY, SUITE A-210
Douglasville, GA 30134

Reassigned Medicare billing, Georgia enrollment
3,885 clinicians in this Medicare group

NPI 1083910046 (770) 949-4188

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30134 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$130.64 typical visit price

range $56.84 – $172.43

Typical copayment $32.66 (range $14.21 – $43.10)

Most-billed visit code 99204

Established Patient

$70.85 typical visit price

range $18.22 – $140.40

Typical copayment $17.71 (range $4.55 – $35.10)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARIE NAKANDE CNM, WHNP-BC

Advanced Practice Midwife