Individual provider Active NPI

William Glen Goncharow, D.O.

  • Emergency Medicine Physician
  • Fort Bragg, NC
National Provider Identifier
1407113103
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2013-01608 Issued in NC
Practice address
2817 Rock Merritt Ave
Fort Bragg, NC 28310-7324
Phone
(910) 907-7136
NPI assigned
Apr 18, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2013-01608 NC Primary
General Practice Physician 208D00000X 2013-01608 NC

Addresses

Primary practice location

2817 Rock Merritt Ave
Fort Bragg, NC 28310-7324

Mailing address

2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001
Phone (910) 907-8116

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220520001526 NC Practitioner - Emergency Medicine 6800023615 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kernersville Emergency Group, PLLCGroup PAC ID 3375885429, 53 clinicians
Piedmont Triad Physicians PLLCGroup PAC ID 6406197334, 37 clinicians
Brunswick Physician Partners PLLCGroup PAC ID 2062752470, 7 clinicians
Brunswick Community Hospital LLCGroup PAC ID 9335150895, 33 clinicians
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians
Tanglewood Park Physicians PLLCGroup PAC ID 3476895129, 47 clinicians

Practice addresses (Care Compare)

1750 Kernersville Medical Pkwy
Kernersville, NC 27284-7146
Phone (336) 564-4850

207 Old Lexington Rd
Thomasville, NC 27360-3428
Phone (336) 472-2000

240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone (910) 721-1000

288 S Ridgecrest Ave
Rutherfordton, NC 28139-2838
Phone (828) 286-5000

6915 Village Medical Cir
Clemmons, NC 27012-8002
Phone (336) 893-1000

Hospital & facility affiliations

  • Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158
  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014
  • Novant Health Thomasville Medical Center Hospital, Thomasville, NC, CCN 340085
  • Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141
  • Rutherford Regional Medical Center Hospital, Rutherfordton, NC, CCN 340013

Merit-based Incentive Payment System (MIPS)

Final score
97.86 of 100Reported as group
Quality
97.48
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as group
Quality
84.49
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
86.5 of 100Reported as group
Quality
84.11
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.02 of 100Reported as group
Quality
82.48
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Brunswick Physician Partners, PLLC Emergency Medicine CurrentSince Sep 1, 2022 Accepting new patients
Tanglewood Park Physicians, PLLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Novant Health Thomasville Medical Center LLC CurrentSince Aug 25, 2022 Accepting new patients
Robeson Emergency Physicians, PLLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Kernersville Emergency Group, PLLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Brunswick Community Hospital, LLC CurrentSince Aug 25, 2022 Accepting new patients
Sandhills Emergency Physicians PA CurrentSince Dec 1, 2022 Accepting new patients
Piedmont Triad Physicians, PLLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Dec 30, 2025 Accepting new patients
Novant Health Thomasville Medical Center, LLC CurrentSince Aug 25, 2022 Accepting new patients
Brunswick Community Hospital, LLC PastSince Oct 13, 2024 Accepting new patients

Locations

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

6915 Village Medical Cir
Clemmons, NC 27012
Phone (336) 718-1680

1750 Kernersville Medical Pkwy
Kernersville, NC 27284
Phone (336) 564-4000

300 W 27th St
Lumberton, NC 28358
Phone (910) 671-5000

155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 11

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1407113103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107324",
            "telephone_number": "910-907-7136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONCHAROW",
        "first_name": "WILLIAM",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2013-01608",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "2013-01608",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, NC

Sources for this page

Verify at the official NPI Registry.