Individual provider Active NPI

McCoy Scott Goforth, NP

  • Pediatric Nurse Practitioner
  • Lincolnton, NC
National Provider Identifier
1568958122
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5010720 Issued in NC
Practice address
447 McAlister Rd
Ste 3300
Lincolnton, NC 28092-4114
Phone
(980) 212-2680
NPI assigned
Jul 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5010720 NC
Pediatric Nurse Practitioner 363LP0200X 5010720 NC Primary

Addresses

Primary practice location

447 McAlister Rd
Ste 3300
Lincolnton, NC 28092-4114

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

10620 Park Rd
Ste 202
Charlotte, NC 28210-8472
Phone (704) 667-0920

Other practice location 2

2101 Shiloh Church Rd
Ste 101
Davidson, NC 28036-7601
Phone (704) 439-3700

Other practice location 3

1085 NE Gateway Ct NE
Ste 290
Concord, NC 28025-2406
Phone (704) 403-4650

Other practice location 4

3396 Cloverleaf Pkwy
Kannapolis, NC 28083-6992
Phone (704) 403-7740

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address mgoforth43685@CarolinasHealthcareSystem.direct-ci.com Atrium Health

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231013001954 NC Practitioner - Nurse Practitioner 5395190151 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5010720NCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Jul 10, 2023 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jul 10, 2023 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

10620 Park Rd
Ste 202
Charlotte, NC 28210
Phone (704) 512-3988

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

2709 Water Ridge Pkwy
Ste 500
Charlotte, NC 28217
Phone (704) 446-9173

2101 Shiloh Church Rd
Ste 101
Davidson, NC 28036
Phone (704) 403-7740

3396 Cloverleaf Pkwy
Kannapolis, NC 28083
Phone (704) 403-7740

447 McAlister Rd
Ste 3300
Lincolnton, NC 28092
Phone (980) 212-2680

Interoperability endpoints

  • Direct secure messaging: mgoforth43685@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1530921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1568958122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 MCALISTER RD",
            "address_2": "STE 3300",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280924114",
            "telephone_number": "980-212-2680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10620 Park Rd",
            "address_2": "Ste 202",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108472",
            "country_code": "US",
            "telephone_number": "704-667-0920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2101 Shiloh Church Rd",
            "address_2": "Ste 101",
            "address_purpose": "LOCATION",
            "city": "Davidson",
            "state": "NC",
            "postal_code": "280367601",
            "country_code": "US",
            "telephone_number": "704-439-3700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1085 NE Gateway Ct NE",
            "address_2": "Ste 290",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252406",
            "country_code": "US",
            "telephone_number": "704-403-4650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3396 Cloverleaf Pkwy",
            "address_purpose": "LOCATION",
            "city": "Kannapolis",
            "state": "NC",
            "postal_code": "280836992",
            "country_code": "US",
            "telephone_number": "704-403-7740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOFORTH",
        "first_name": "MCCOY",
        "middle_name": "SCOTT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-07",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5010720",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5010720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgoforth43685@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "447 McAlister Rd",
            "address_2": "Ste 3300",
            "city": "Lincolnton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280924114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lincolnton, NC

Sources for this page

Verify at the official NPI Registry.