Individual provider Active NPI

Luisa Fernanda Gonzalez, MD

  • Pediatrics Physician
  • Rocky Mount, NC
National Provider Identifier
1023645637
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2025-02383 Issued in NC
Practice address
91 Enterprise Dr
Rocky Mount, NC 27804-9590
Phone
(252) 451-3100
Fax
(252) 937-3106
NPI assigned
Mar 24, 2020
Last updated
Dec 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2025-02383 NC Primary
Pediatrics Physician 208000000X A185706 CA

Addresses

Primary practice location

91 Enterprise Dr
Rocky Mount, NC 27804-9590

Mailing address

PO Box 7200
Rocky Mount, NC 27804-0200
Phone (252) 937-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240425002579 CA Practitioner - Pediatric Medicine 9931549862 Reassigns benefits to 1 organization
I20251015001423 NC Practitioner - Pediatric Medicine 9931549862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 7200
Rocky Mount, NC 27804

PO Box
Suite 7200
Rocky Mount, NC 27804-0200

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Mar 13, 2024 Accepting new patients
Boice-Willis Clinic PA Pediatrics CurrentSince Nov 3, 2025 Accepting new patients
Boice-Willis Clinic, PA CurrentSince Nov 3, 2025 Accepting new patients

Locations

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

4650 W Sunset Blvd
#87
Los Angeles, CA 90027

901 N Winstead Ave
Rocky Mount, NC 27804
Phone (252) 937-0200

91 Enterprise Dr
Rocky Mount, NC 27804
Phone (252) 451-3100

921 N Winstead Ave
Rocky Mount, NC 27804
Phone (252) 937-0300

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": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1023645637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7200",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278040200",
            "telephone_number": "252-937-0200",
            "fax_number": "252-451-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 ENTERPRISE DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278049590",
            "telephone_number": "252-451-3100",
            "fax_number": "252-937-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "LUISA",
        "middle_name": "FERNANDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2025-02383",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A185706",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

Verify at the official NPI Registry.