Ishwar Hakumal Gopichand, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

9600796 Issued in NC

Practice address

118 Memorial Dr
Jacksonville, NC 28546-6328

Phone

(910) 353-0581

Fax

(910) 577-1150

NPI assigned

May 19, 2006

Last updated

Nov 3, 2023By the provider in NPPES

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

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

Specialty

Pediatric Medicine

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jacksonville Children's and Multispecialty Clinic, PAGroup PAC ID 6709968811, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jacksonville Children's and Multispecialty Clinic, PA

  • Family Medicine Physician
  • Jacksonville, NC
  • NPI 1164519070

  Pediatrics

  Medicare reassignment Care Compare group NPD Authorized official
• Amm Healthcare, PA

  • Family Medicine Physician
  • Cary, NC
  • NPI 1528639689

  Pediatrics

  NPD
• Jacksonville Behavior and Mental Health

  • Adolescent and Children Mental Health Clinic/Center
  • Jacksonville, NC
  • NPI 1770771750
  NPD
• Family Care Clinic, P.a.

  • Clinic/Center
  • Jacksonville, NC
  • NPI 1316033590
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1538113261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 986513",
            "address_2": "DEPARTMENT 100",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986513",
            "telephone_number": "910-219-8326",
            "fax_number": "910-939-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MEMORIAL DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466328",
            "telephone_number": "910-353-0581",
            "fax_number": "910-577-1150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466328",
            "country_code": "US",
            "telephone_number": "910-353-0581",
            "fax_number": "910-353-1536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "108 Lakeside Dr.",
            "address_purpose": "LOCATION",
            "city": "Sneads Ferry",
            "state": "NC",
            "postal_code": "28460",
            "country_code": "US",
            "telephone_number": "910-325-0581",
            "fax_number": "910-325-0582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 S Wilmington St",
            "address_purpose": "LOCATION",
            "city": "Richlands",
            "state": "NC",
            "postal_code": "285748298",
            "country_code": "US",
            "telephone_number": "910-324-7268",
            "fax_number": "910-324-7273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOPICHAND",
        "first_name": "ISHWAR",
        "middle_name": "HAKUMAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9600796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8936271",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jean C Gonzalez, MS. CCC-SLP
• Owen Gonzalez, CPO
• Shannice Gonzalez
• Kasey Elizabeth Goodman, PT
• Kaylea Goodson, FNP-BC
• Stacey Gore, PTA
• Jacqueline Gorrell, HIS
• Goshen Medical Center Incorporated
• Goshen Medical Center Incorporated (GMC Pharmacy at Jacksonville)
• Goshen Medical Center, Inc. (Goshen Medical Center-Jacksonville)

• Pediatrics Physician in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.