NPIMap

Organization Active NPI

Dublin OB-GYN & Associates, P.C.

  • Specialist
  • Dublin, GA
National Provider Identifier
1609916337
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
052127 Issued in GA
Legal business name
DUBLIN OB-GYN & ASSOCIATES, P.C.
Practice address
23 Erin Office Park
2400 Bellevue Road
Dublin, GA 31021-2866
Phone
(478) 272-8580
Fax
(478) 275-0012
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Authorized official

Name
Mrs. Jennifer P Simons
Title
Administrative Assistant
Phone
(478) 272-8580

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 017442 GA
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 052127 GA Primary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 017714 GA

Addresses

Primary practice location

23 Erin Office Park
2400 Bellevue Road
Dublin, GA 31021-2866

Mailing address

23 Erin Office Park
2400 Bellevue Road
Dublin, GA 31021-2866
Phone (478) 272-8580

Other identifiers 3

IdentifierTypeStateIssuer
00083531DMedicaidGA
00082233AMedicaidGA
224745520AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040429000425 GA Part B Supplier - Clinic/Group Practice 2860489986 Receives reassigned benefits from 1 practitioner
Practice locations: Dublin, GA

National Provider Directory

National Provider Directory

Locations

2400 Bellevue Rd
Ste 23
Dublin, GA 31021
Phone (478) 272-8580

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3170/brand/1/csg/1/fhir/r4

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": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612137600000",
    "number": "1609916337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 ERIN OFFICE PARK",
            "address_2": "2400 BELLEVUE ROAD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212866",
            "telephone_number": "478-272-8580",
            "fax_number": "478-275-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 ERIN OFFICE PARK",
            "address_2": "2400 BELLEVUE ROAD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212866",
            "telephone_number": "478-272-8580",
            "fax_number": "478-275-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBLIN OB-GYN & ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A",
        "authorized_official_last_name": "SIMONS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "478-272-8580",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "017442",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "052127",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "017714",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00083531D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00082233A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "224745520A",
            "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 Feb 1, 2021; 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.