NPIMap

Organization Active NPI

Goshen Medical Center, Inc.

Doing business as Goshen Medical Center-Jacksonville

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, NC
National Provider Identifier
1801676994
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GOSHEN MEDICAL CENTER, INC.
Doing business as
Goshen Medical Center-Jacksonville
Practice address
158 Memorial CT
Jacksonville, NC 28546-6322
Phone
(910) 267-0421
Fax
(910) 267-0441
NPI assigned
Oct 5, 2023
Last updated
Mar 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

158 Memorial CT
Jacksonville, NC 28546-6322

Mailing address

PO Box 187
Faison, NC 28341-0187
Phone (910) 267-2057

Other names 1

  • GOSHEN MEDICAL CENTER-JACKSONVILLE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040102000726 NC Part B Supplier - Clinic/Group Practice 3173434479 Receives reassigned benefits from 224 practitioners
45 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kenansville, NC; Morehead City, NC; Mount Olive, NC; New Bern, NC; Rockingham, NC; Rose Hill, NC; Sanford, NC; Southport, NC…
O20231110002104 NC Part A Provider - Federally Qualified Health Center (FQHC) 3173434479 Practice locations: Jacksonville, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801676994. Details of each certification follow.

Federally qualified health center certification: CCN B61012

Legal name
GOSHEN MEDICAL CENTER INCORPORATED
Doing business as
GOSHEN MEDICAL CENTER - JACKSONVILLE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 10, 2023
Last certification
Nov 10, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 29, 1979 in NC
Enrollment address
158 Memorial CT
Jacksonville, NC 28546-6322

Other NPIs on the same Medicare enrollment 44

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 44

National Provider Directory

National Provider Directory
Tax ID family
Goshen Medical Ctr42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

Locations

158 Memorial Ct
Jacksonville, NC 28546
Phone (910) 219-3301

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Rhonda Barwick Individual Corporate Officer Sep 12, 2023
W-2 Managing Employee Sep 12, 2023
Operational/Managerial Control Sep 12, 2023
Gregory M Bounds Individual W-2 Managing EmployeeCeo Sep 12, 2023
Operational/Managerial ControlCeo Sep 12, 2023

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Goshen Medical Center-Whiteville Mobile UnitWhiteville, NC, CCN 341007 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2012
Goshen Medical Center-Cape FearFayetteville, NC, CCN 341012 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 1, 2014
Goshen Medical Center-New BernNew Bern, NC, CCN 341022 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 25, 2014
Goshen Medical Center-FairviewClinton, NC, CCN 341019 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2014
Goshen Medical Center - DunnDunn, NC, CCN 341083 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 4, 2017
Goshen Medical Center - New BernNew Bern, NC, CCN B61075 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 2, 2025
Goshen Medical Center - WilmingtonWilmington, NC, CCN B61090 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1696464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1801676994",
    "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": "910-267-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 MEMORIAL CT",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466322",
            "telephone_number": "910-267-0421",
            "fax_number": "910-267-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOSHEN MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-05",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "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": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOSHEN MEDICAL CENTER-JACKSONVILLE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.