Michael Gough, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

102470 Issued in NC

Practice address

1800 W 5TH St
Suites 2 & 4
Greenville, NC 27834-2888

Phone

(252) 744-2207

Fax

(252) 744-3987

NPI assigned

Dec 30, 2005

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• East Carolina University

  dba ECU Physicians

  • Obstetrics & Gynecology Physician
  • Greenville, NC
  • NPI 1528016938
  NPD (past)
• East Carolina University

  dba ECU Physicians

  • Pediatrics Physician
  • Greenville, NC
  • NPI 1730139171
  NPD (past)

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271635200000",
    "number": "1396722286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751069",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069",
            "telephone_number": "252-744-3253",
            "fax_number": "252-744-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W 5TH ST",
            "address_2": "SUITES 2 & 4",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342888",
            "telephone_number": "252-744-2207",
            "fax_number": "252-744-3987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGH",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2010-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "102470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "970012691",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Mary Goth, M.D.
• Tafadzwa Precious Goto, NP
• Elizabeth Ann Gottsch, PHYSICIAN ASSISTANT
• Lauren Gottschalk, BCBA
• John E Gough, MD
• Naira Goukasian, MD
• Samuel Gould
• Patreece Payne Govea, LCSWA
• Gowen Counseling and Wellness
• Laurel Gowen

• Medical Physician Assistant in Greenville, NC
• Providers in Greenville, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.