Individual provider Active NPI

Johnny S Gomes, DO

  • Emergency Medicine Physician
  • Hickory, NC
National Provider Identifier
1780612077
Registry record updated Jun 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
146002 Issued in NC
Practice address
420 N Center St
Hickory, NC 28601-5046
Phone
(828) 315-5636
Fax
(828) 315-5656
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MB07443700 NJ
Emergency Medicine Physician 207P00000X 146002 NC Primary

Addresses

Primary practice location

420 N Center St
Hickory, NC 28601-5046

Mailing address

420 N Center St
Hickory, NC 28601-5046
Phone (828) 315-5636

Other identifiers 4

IdentifierTypeStateIssuer
2646716000OtherNJAMERIHEALTH
P00161477OtherNJRAILROAD MEDICARE
60018859OtherNJHORIZON NJ HEALTH
8960003MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 1, 2024 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
146002NCMDEmergency Medicine Physician
25MB07443700NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Emergency Associates, PA Emergency Medicine PastSince Feb 8, 2023 Accepting new patients
Washington County Emergency Medicine Physicians, LLC Past Accepting new patients
Tidal Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Caldwell Emergency Medical Associates LLC Emergency Medicine Past Accepting new patients
Leeds Emergency Physicians Emergency Medicine Past Accepting new patients

Organizations & group practices 5

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244851200000",
    "number": "1780612077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 N CENTER ST",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015046",
            "telephone_number": "828-315-5636",
            "fax_number": "828-315-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N CENTER ST",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015046",
            "telephone_number": "828-315-5636",
            "fax_number": "828-315-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMES",
        "first_name": "JOHNNY",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2009-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB07443700",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "146002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2646716000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00161477",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "60018859",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8960003",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.