Active NPI
Johnny S Gomes, DO
- Emergency Medicine Physician
- Hickory, NC
National Provider Identifier
1780612077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 146002
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2646716000 | Other | NJ | AMERIHEALTH |
| P00161477 | Other | NJ | RAILROAD MEDICARE |
| 60018859 | Other | NJ | HORIZON NJ HEALTH |
| 8960003 | Medicaid | NJ |
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
- 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.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146002 | NC | MD | Emergency Medicine Physician |
| 25MB07443700 | NJ | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlantic Emergency Associates, PA | Emergency Medicine | Past | 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.
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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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2009; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.