Organization Active NPI

Goldsboro Endoscopy Center Inc

  • Ambulatory Surgical Clinic/Center
  • Goldsboro, NC
National Provider Identifier
1205804697
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
AS0057 Issued in NC
Legal business name
GOLDSBORO ENDOSCOPY CENTER INC
Practice address
2705 Medical Office PL
Goldsboro, NC 27534-9458
Phone
(919) 580-9111
Fax
(919) 580-0988
NPI assigned
Mar 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. V C Motaparthy, MD
Title
Medical Director
Phone
(919) 580-9111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X AS0057 NC Primary

Addresses

Primary practice location

2705 Medical Office PL
Goldsboro, NC 27534-9458

Mailing address

2705 Medical Office PL
Goldsboro, NC 27534-9458
Phone (919) 580-9111

Other identifiers 2

IdentifierTypeStateIssuer
00678OtherNCBCBSNC PROVIDER #
3409905MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040319000534 NC Part B Supplier - Ambulatory Surgical Center 5294625463 Receives reassigned benefits from 3 practitioners
Practice locations: Goldsboro, NC

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Goldsboro Endoscopy CenterCCN 34C0001040
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205804697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 MEDICAL OFFICE PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349458",
            "telephone_number": "919-580-9111",
            "fax_number": "919-580-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 MEDICAL OFFICE PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349458",
            "telephone_number": "919-580-9111",
            "fax_number": "919-580-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDSBORO ENDOSCOPY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOTAPARTHY",
        "authorized_official_first_name": "V",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "919-580-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NC",
            "license": "AS0057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC PROVIDER #",
            "identifier": "00678",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409905",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.