Phillip Daniel Goldsborough

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R193305 Issued in MD

Practice address

12145 Elm St
Princess Anne, MD 21853-1358

Phone

(410) 651-2204

Fax

(410) 651-0790

NPI assigned

Mar 9, 2023

Last updated

Jul 31, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 MD, DC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Wake Forest University School of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Axis Healthcare GroupGroup PAC ID 1254409550, 76 clinicians

Three Lower Counties Community Services IncGroup PAC ID 3678484300, 74 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019
• Medstar Saint Mary's Hospital Hospital, Leonardtown, MD, CCN 210028
• University of MD Capital Region Medical Center Hospital, Upper Marlboro, MD, CCN 210003

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: phillip.goldsborough.1@3167.direct.athenahealth.com

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.

• Axis Healthcare Group

  dba CareMind Health

  • Psychiatry Physician
  • Silver Spring, MD
  • NPI 1326295098

  DC

  Medicare reassignment Care Compare group NPD
• Three Lower Counties Community Services, Inc.

  dba Chesapeake Health Care

  • Federally Qualified Health Center (FQHC)
  • Princess Anne, MD
  • NPI 1154354744
  Medicare reassignment Care Compare group NPD
• Three Lower Counties Community Services Inc

  dba Delmarva Pharmacy

  • Community/Retail Pharmacy
  • Salisbury, MD
  • NPI 1194768473
  NPD
• Three Lower Counties Community Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Salisbury, MD
  • NPI 1275405714
  NPD
• MCS, PC

  dba Mindoula Health, Inc.

  • Community/Behavioral Health Agency
  • Silver Spring, MD
  • NPI 1538717723

  Psychiatric/Mental Health

  NPD (past)

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

• Dimensions Health Corporation

  dba University of Maryland Bowie Health Center

  • General Acute Care Hospital
  • Upper Marlboro, MD
  • NPI 1720099286
  Care Compare affiliation
• St Marys Hospital of St Marys County Inc

  dba MedStar St. Mary's Hospital

  • General Acute Care Hospital
  • Leonardtown, MD
  • NPI 1780650473
  Care Compare affiliation
• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  Care Compare affiliation

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1750081550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218021978",
            "telephone_number": "410-749-1015",
            "fax_number": "410-749-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12145 ELM ST",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218531358",
            "telephone_number": "410-651-2204",
            "fax_number": "410-651-0790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Carroll St",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218015422",
            "country_code": "US",
            "telephone_number": "202-360-4787",
            "fax_number": "202-360-4787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDSBOROUGH",
        "first_name": "PHILLIP",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-09",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R193305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steve Giddens
• John Francis Gilligan, LCSW-C
• Go-Getters, Inc.
• Go-Getters, Inc.
• Go-Getters, Inc.
• Janell Good, PA
• Gregorio M. Belloso M.D. P.a.
• Griffin Enterprises LLC
• Griffin Enterprises LLC
• Michelle Grinberg, DMD

• Psychiatric/Mental Health Nurse Practitioner in Princess Anne, MD
• Providers in Princess Anne, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.