Goshen Medical Center Incorporated

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

GOSHEN MEDICAL CENTER INCORPORATED

Practice address

4833 Carolina Beach Rd Ste 106
Wilmington, NC 28412-2370

Phone

(910) 332-7900

Fax

(910) 500-7469

NPI assigned

Sep 3, 2021

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

• PELICAN FAMILY MEDICINE - CAROLINA BEACH Doing business as

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633478400000",
    "number": "1730857640",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4833 CAROLINA BEACH RD STE 106",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122370",
            "telephone_number": "910-332-7900",
            "fax_number": "910-500-7469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOSHEN MEDICAL CENTER INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PELICAN FAMILY MEDICINE - CAROLINA BEACH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PELICAN FAMILY MEDICINE - CAROLINA BEACH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Gore, PA
• Sudie Brown Gorges
• Robert Gorlach, LCSW
• Goshen Medical Center Incorporated
• Goshen Medical Center Incorporated
• Benjamin Robert Gosselin, DDS
• Bernard Gottschalk, MD
• Hormoze A Goudarzi, M.D.
• Kamran Goudarzi, M.D.
• Cailyn Grace Gould

• Federally Qualified Health Center (FQHC) in Wilmington, NC
• Providers in Wilmington, 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 Oct 6, 2021; 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.