Organization Active NPI

Dublin Ear Nose and Throat Associates, P.C.

  • Otolaryngology Physician
  • Dublin, GA
National Provider Identifier
1184778425
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
DUBLIN EAR NOSE AND THROAT ASSOCIATES, P.C.
Practice address
102 Fairview Park Dr
Dublin, GA 31021-2500
Phone
(478) 272-8382
Fax
(478) 275-1964
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Amanda D Asbell
Title
Practice Manager
Phone
(478) 272-8382

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X GA Primary

Addresses

Primary practice location

102 Fairview Park Dr
Dublin, GA 31021-2500

Mailing address

102 Fairview Park Dr
Dublin, GA 31021-2500
Phone (478) 272-8382

Other identifiers 4

IdentifierTypeStateIssuer
00608924AMedicaidGA
1D629296052AMedicaidGA
003202402AMedicaidGA
629296052AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080604000232 GA Part B Supplier - Clinic/Group Practice 3779653654 Receives reassigned benefits from 4 practitioners
Practice locations: Dublin, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0985467Dublin Ear Nose & Throat Associates, LLC102 Fairview Park Drive, Dublin, GA 31021Certificate of waiverMar 6, 2028

National Provider Directory

National Provider Directory

Locations

102 Fairview Park Dr
Dublin, GA 31021
Phone (478) 272-8382

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1184778425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 FAIRVIEW PARK DR",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212500",
            "telephone_number": "478-272-8382",
            "fax_number": "478-275-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 FAIRVIEW PARK DR",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212500",
            "telephone_number": "478-272-8382",
            "fax_number": "478-275-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBLIN EAR NOSE AND THROAT ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "ASBELL",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "478-272-8382"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00608924A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1D629296052A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003202402A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "629296052A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.