NPIMap

Organization Active NPI

Jacksonville Children's and Multispecialty Clinic, PA

  • Family Medicine Physician
  • Jacksonville, NC
National Provider Identifier
1164519070
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JACKSONVILLE CHILDREN'S AND MULTISPECIALTY CLINIC, PA
Practice address
118 Memorial Dr
Jacksonville, NC 28546-6328
Phone
(910) 353-0581
Fax
(910) 353-1351
NPI assigned
Oct 10, 2006
Last updated
Jan 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Authorized official

Name
Ishwar Hakumal Gopichand, MDNPI 1538113261
Title
Cmo
Phone
(919) 589-1240

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Gastroenterology Physician 207RG0100X
Pediatrics Physician 208000000X
Neonatal-Perinatal Medicine Physician 2080N0001X
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X
Pediatric Cardiology Physician 2080P0202X

Addresses

Primary practice location

118 Memorial Dr
Jacksonville, NC 28546-6328

Mailing address

PO Box 986513
Department 100
Boston, MA 02298-6513
Phone (910) 219-8326

Other practice location 1

8399 Richlands Hwy
Richlands, NC 28574-7390
Phone (910) 324-7268

Other practice location 2

114A Memorial Dr
Jacksonville, NC 28546-6328
Phone (910) 353-0700

Other practice location 3

3004 Bridges St
Morehead City, NC 28557-3330
Phone (252) 727-4933

Other practice location 4

319 Wb McLean Dr
Cape Carteret, NC 28584-8516
Phone (252) 424-0004

Other practice location 5

5710 Oleander Dr Ste 200
Wilmington, NC 28403-4722
Phone (910) 799-1810

Other practice location 6

120 Memorial Dr
Jacksonville, NC 28546-6328
Phone (910) 353-0581

Other practice location 7

156 Memorial Ct
Jacksonville, NC 28546-6322
Phone (910) 353-0680

Other practice location 8

114C Memorial Dr
Jacksonville, NC 28546-6328
Phone (910) 353-9688

Other practice location 9

107 S Wilmington St
Richlands, NC 28574-8298
Phone (910) 324-7268

Other practice location 10

108 Lakeside Dr
Sneads Ferry, NC 28460-9415
Phone (910) 327-5437

Other practice location 11

1106 Main Street Ext
Swansboro, NC 28584-9114
Phone (910) 325-0581

Other practice location 12

152 Memorial Ct
Jacksonville, NC 28546-6322
Phone (910) 219-8326

Other identifiers 1

IdentifierTypeStateIssuer
1164519070MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080129000277 NC Part B Supplier - Clinic/Group Practice 6709968811 Receives reassigned benefits from 76 practitioners
Practice locations: Newport, NC; Wilmington, NC; Swansboro, NC; Sneads Ferry, NC; Richlands, NC; Morehead City, NC; Jacksonville, NC; Cape Carteret, NC

National Provider Directory

National Provider Directory

Locations

331 W Main St
#C
Havelock, NC 28532
Phone (252) 444-1461

144 Memorial Ct
Jacksonville, NC 28546
Phone (910) 346-3976

152 Memorial Ct
Jacksonville, NC 28546
Phone (910) 346-3976

10208 Cerny St
Ste 301
Raleigh, NC 27617
Phone (919) 354-7077

107 S Wilmington St
Richlands, NC 28574
Phone (910) 324-7268

8399 Richlands Hwy
Richlands, NC 28574
Phone (910) 324-7268

5710 Oleander Dr
Ste 200
Wilmington, NC 28403
Phone (910) 799-1810

Practitioners & affiliated clinicians

Practitioners 94

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 94

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768780800000",
    "number": "1164519070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 986513",
            "address_2": "DEPARTMENT 100",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986513",
            "telephone_number": "910-219-8326",
            "fax_number": "910-939-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MEMORIAL DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466328",
            "telephone_number": "910-353-0581",
            "fax_number": "910-353-1351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8399 Richlands Hwy",
            "address_purpose": "LOCATION",
            "city": "Richlands",
            "state": "NC",
            "postal_code": "285747390",
            "country_code": "US",
            "telephone_number": "910-324-7268",
            "fax_number": "910-324-7273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "114A Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466328",
            "country_code": "US",
            "telephone_number": "910-353-0700",
            "fax_number": "910-353-5305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3004 Bridges St",
            "address_purpose": "LOCATION",
            "city": "Morehead City",
            "state": "NC",
            "postal_code": "285573330",
            "country_code": "US",
            "telephone_number": "252-727-4933",
            "fax_number": "252-727-4936",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "319 Wb McLean Dr",
            "address_purpose": "LOCATION",
            "city": "Cape Carteret",
            "state": "NC",
            "postal_code": "285848516",
            "country_code": "US",
            "telephone_number": "252-424-0004",
            "fax_number": "252-764-0019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5710 Oleander Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284034722",
            "country_code": "US",
            "telephone_number": "910-799-1810",
            "fax_number": "910-799-9644",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466328",
            "country_code": "US",
            "telephone_number": "910-353-0581",
            "fax_number": "910-577-1150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "156 Memorial Ct",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466322",
            "country_code": "US",
            "telephone_number": "910-353-0680",
            "fax_number": "910-353-3629",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "114C Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466328",
            "country_code": "US",
            "telephone_number": "910-353-9688",
            "fax_number": "910-353-7498",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 S Wilmington St",
            "address_purpose": "LOCATION",
            "city": "Richlands",
            "state": "NC",
            "postal_code": "285748298",
            "country_code": "US",
            "telephone_number": "910-324-7268",
            "fax_number": "910-324-7273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "108 Lakeside Dr",
            "address_purpose": "LOCATION",
            "city": "Sneads Ferry",
            "state": "NC",
            "postal_code": "284609415",
            "country_code": "US",
            "telephone_number": "910-327-5437",
            "fax_number": "910-327-5436",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1106 Main Street Ext",
            "address_purpose": "LOCATION",
            "city": "Swansboro",
            "state": "NC",
            "postal_code": "285849114",
            "country_code": "US",
            "telephone_number": "910-325-0581",
            "fax_number": "910-325-0582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "152 Memorial Ct",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466322",
            "country_code": "US",
            "telephone_number": "910-219-8326",
            "fax_number": "910-353-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACKSONVILLE CHILDREN'S AND MULTISPECIALTY CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A",
        "authorized_official_last_name": "GOPICHAND",
        "authorized_official_first_name": "ISHWAR",
        "authorized_official_middle_name": "HAKUMAL",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "919-589-1240",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164519070",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2026; 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.