Active NPI
Bahman Malekpour, M.D.
- Psychiatry Physician
- Goldsboro, NC
National Provider Identifier
1366468399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 21359
- Practice address
- 2805 McLamb PL
Goldsboro, NC 27534-1647 - Phone
- (919) 734-2222
- Fax
- (919) 734-2229
- NPI assigned
- Jul 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 21359 | NC | Primary |
Addresses
Primary practice location
2805 McLamb PL
Goldsboro, NC 27534-1647
Mailing address
PO Box 1342
Goldsboro, NC 27533-1342
Phone (919) 734-2222
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 53772 | Other | NC | BLUE CROSS INDIVIDUAL |
| 8953772 | Medicaid | NC | |
| 890184G | Medicaid | NC | |
| 0184G | Other | NC | BLUE CROSS GROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2024 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Synergy Wellness Clinic, PLLC | Current | Accepting new patients |
Locations
2805 McLamb Pl
Goldsboro, NC 27534
Phone (919) 734-2222
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Goldsboro, NC
- NPI 1386324622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352678400000",
"number": "1366468399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1342",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275331342",
"telephone_number": "919-734-2222",
"fax_number": "919-734-2229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2805 MCLAMB PL",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275341647",
"telephone_number": "919-734-2222",
"fax_number": "919-734-2229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALEKPOUR",
"first_name": "BAHMAN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-14",
"last_updated": "2012-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "21359",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS INDIVIDUAL",
"identifier": "53772",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8953772",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890184G",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS GROUP",
"identifier": "0184G",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
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- Kiara Manley
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.