Providence Obgyn LLC
NPI 1124750369 · Obstetrics & Gynecology Physician · Dublin, GA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Providence Obgyn LLC is a Obstetrics & Gynecology Physician organization in Dublin, GA (NPI 1124750369).
Provider details
- NPI number
- 1124750369
- Entity type
- Organization
- Primary specialty
- Obstetrics & Gynecology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Lauri Bullen, Sole Partner(843) 614-9917
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 227 Industrial BlvdDublin, GA 31021-2969Phone: (478) 246-4304Fax: (478) 246-4282
Registry dates
- Enumerated
- 2022-06-27
- Last updated
- 2025-11-17
- Certified
- 2025-11-17
Frequently asked questions
- What is Providence Obgyn LLC's NPI number?
- Providence Obgyn LLC's National Provider Identifier (NPI) is 1124750369, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Providence Obgyn LLC?
- Providence Obgyn LLC is classified in the NPPES registry as Obstetrics & Gynecology Physician (Allopathic & Osteopathic Physicians).
- Where is Providence Obgyn LLC located?
- Providence Obgyn LLC's practice location on file with NPPES is 206 Fairview Park Dr, Dublin, GA 31021-2547.
- What is Providence Obgyn LLC's phone number?
- The practice phone number listed in the NPPES registry for Providence Obgyn LLC is (478) 246-4304.
- Does Providence Obgyn LLC accept Medicare?
- Providence Obgyn LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Providence Obgyn LLC?
- The authorized official listed on Providence Obgyn LLC's NPPES record is Lauri Bullen, Sole Partner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Providence Obgyn LLC's NPI active?
- Yes — Providence Obgyn LLC's NPI (1124750369) is active in the NPPES registry as of the last update on 2025-11-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.