Goshen Medical Center, Incorporated

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

GOSHEN MEDICAL CENTER, INCORPORATED

Doing business as

Goshen Medical Center - Morehead City

Practice address

4370A Arendell St
Morehead, NC 28557

Phone

(252) 222-0204

Fax

(910) 267-1237

NPI assigned

Jan 11, 2018

Last updated

Jan 11, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gregory M Bounds

Title

Ceo

Phone

(910) 267-1237

Specialties & licenses 1

Addresses

Other names 1

• Goshen Medical Center - Morehead City Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487162434. Details of each certification follow.

• CCN 341084 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 341084

Legal name

GOSHEN MEDICAL CENTER-MOREHEAD CITY

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

May 9, 2018

Last certification

May 9, 2018

Ownership / control type

For profit – corporation

Facility address

4370 Arendell St, Suite a
Morehead City, NC 28557

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515628800000",
    "number": "1487162434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 187",
            "city": "FAISON",
            "state": "NC",
            "postal_code": "283410187",
            "telephone_number": "910-267-2042",
            "fax_number": "855-996-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370A ARENDELL ST",
            "city": "MOREHEAD",
            "state": "NC",
            "postal_code": "28557",
            "telephone_number": "252-222-0204",
            "fax_number": "910-267-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOSHEN MEDICAL CENTER, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-11",
        "last_updated": "2018-01-11",
        "status": "A",
        "authorized_official_last_name": "BOUNDS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-267-1237"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goshen Medical Center - Morehead City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Federally Qualified Health Center (FQHC) in Morehead, NC
• Providers in Morehead, NC by specialty
• Federally Qualified Health Center (FQHC) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.