Individual provider Active NPI

Augustus J Goforth III, MD

  • Otolaryngology Physician
  • Greenville, SC
National Provider Identifier
1013915347
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
SC10344 Issued in SC
Practice address
131 Commonwealth Dr
Suite 230
Greenville, SC 29615-4883
Phone
(864) 281-9440
Fax
(864) 281-9443
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X SC10344 SC Primary

Addresses

Primary practice location

131 Commonwealth Dr
Suite 230
Greenville, SC 29615-4883

Mailing address

131 Commonwealth Dr
Suite 230
Greenville, SC 29615-4883
Phone (864) 281-9440

Other identifiers 1

IdentifierTypeStateIssuer
103444MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10344SCMDOrthodontics and Dentofacial Orthopedic Dentist
SC10344SCMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina ENT, PA Otolaryngology Past Accepting new patients
St Francis Hospital Inc Past Accepting new patients
Carolina ENT, PA Otolaryngology PastSince Mar 1, 1999 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1013915347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 COMMONWEALTH DR",
            "address_2": "SUITE 230",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154883",
            "telephone_number": "864-281-9440",
            "fax_number": "864-281-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 COMMONWEALTH DR",
            "address_2": "SUITE 230",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154883",
            "telephone_number": "864-281-9440",
            "fax_number": "864-281-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFORTH",
        "first_name": "AUGUSTUS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "SC10344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103444",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.