NPIMap

Organization Active NPI

Ogeechee OB-GYN, LLC

  • Obstetrics & Gynecology Physician
  • Statesboro, GA
National Provider Identifier
1033324629
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
OGEECHEE OB-GYN, LLC
Practice address
1310 Brampton Ave
Statesboro, GA 30458-0851
Phone
(912) 871-6206
Fax
(912) 681-8558
NPI assigned
May 14, 2007
Last updated
Sep 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Authorized official

Name
Jennifer Hendrix
Title
Credentialing Coordinator
Phone
(912) 515-3546

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

1310 Brampton Ave
Statesboro, GA 30458-0851

Mailing address

1310 Brampton Ave
Statesboro, GA 30458-0851
Phone (912) 871-6206

Other identifiers 1

IdentifierTypeStateIssuer
300019870AOtherGAMEDICAID GROUP

Other names 1

  • OGEECHEE OB-GYN, PC Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL tclark@ogeecheeobgyn.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040526000187 GA Part B Supplier - Clinic/Group Practice 0244211308 Receives reassigned benefits from 7 practitioners
Practice locations: Statesboro, GA; Sylvania, GA; Swainsboro, GA

National Provider Directory

National Provider Directory

Locations

1301 Brampton Ave
Statesboro, GA 30458

1310 Brampton Ave
Statesboro, GA 30458
Phone (912) 486-1873

1501 Brampton Ave
Statesboro, GA 30458
Phone (912) 871-6206

9 S Main St
Statesboro, GA 30458
Phone (912) 420-4770

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1033324629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 BRAMPTON AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580851",
            "telephone_number": "912-871-6206",
            "fax_number": "912-681-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 BRAMPTON AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580851",
            "telephone_number": "912-871-6206",
            "fax_number": "912-681-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OGEECHEE OB-GYN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A",
        "authorized_official_last_name": "HENDRIX",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "912-515-3546"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "300019870A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "tclark@ogeecheeobgyn.com",
            "affiliation": "N",
            "address_1": "1310 Brampton Ave",
            "city": "Statesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "304580851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "OGEECHEE OB-GYN, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.