J. D. Gupta, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

019694 Issued in NC

Practice address

2704 Medical Office PL
Goldsboro, NC 27534-9460

Phone

(919) 736-4724

Fax

(919) 736-1677

NPI assigned

Apr 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Wayne Memorial Hospital Inc

  • General Acute Care Hospital
  • Goldsboro, NC
  • NPI 1750353462
  Medicare reassignment NPD
• Wayne Memorial Hospital Inc

  • Psychiatric Hospital Unit
  • Goldsboro, NC
  • NPI 1215105713
  NPD
• Bluebell Health & Wellness, PLLC

  • Rural Health Clinic/Center
  • Goldsboro, NC
  • NPI 1740940790
  NPD (past)

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1063476935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 MEDICAL OFFICE PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349460",
            "telephone_number": "919-736-4724",
            "fax_number": "919-736-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 MEDICAL OFFICE PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349460",
            "telephone_number": "919-736-4724",
            "fax_number": "919-736-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "J.",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "019694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8937894",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "37894",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendy J Griffin, MS,CCC-A
• Growth, LLC
• Marian W Gudger, P.A.
• Ellane Guiao
• Gool K Gupta, M.D.
• Josie Gurganus, LMBT
• Regina Gurley, PA-C
• GVNR, LLC
• H. G. Moore, III & Associates, P.a.
• H2 Alliance Team LLC

• Specialist in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.