NPIMap

Organization Active NPI

Goshen Medical Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Rose Hill, NC
National Provider Identifier
1801911383
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GOSHEN MEDICAL CENTER INCORPORATED
Practice address
360 E Charity Rd
Rose Hill, NC 28458-8303
Phone
(910) 289-3086
Fax
(910) 289-2413
NPI assigned
Mar 21, 2007
Last updated
Aug 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

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

Authorized official

Name
Reba W. Futrell
Title
Executive Assistant Credentialing
Phone
(910) 267-9997

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

360 E Charity Rd
Rose Hill, NC 28458-8303

Mailing address

412 SW Center St
Faison, NC 28341-8820
Phone (910) 267-0421

Other identifiers 2

IdentifierTypeStateIssuer
0122COtherNCBCBS
344557AMedicaidNC

Other names 1

  • Plainview Health Services Other name

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…
O20101005000551 NC Part A Provider - Federally Qualified Health Center (FQHC) 3173434479 Practice locations: Rose Hill, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801911383. Details of each certification follow.

Federally qualified health center certification: CCN 341838

Legal name
GOSHEN MEDICAL CENTER INCORPORATED
Doing business as
PLAINVIEW HEALTH SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 1, 1993
Last certification
Jan 1, 1993
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
May 29, 1979 in NC
Enrollment address
360 E Charity Rd
Rose Hill, NC 28458-8303

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

360 E Charity Rd
Rose Hill, NC 28458
Phone (910) 289-3086

Ownership & related parties

All disclosed owners & managing parties 9

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 W-2 Managing EmployeeDirector of Operations Sep 27, 2001
Chester Aycock Individual Corporate DirectorBoard Member Feb 1, 2008 100%
Tanty Freeman Individual Corporate DirectorBoard Member Feb 1, 2008 100%
Patricia a Davis Individual Corporate DirectorBoard Member Feb 1, 2008 11.11%
Gregory M Bounds Individual Corporate OfficerCeo Jan 2, 2004
W-2 Managing EmployeeCeo Jan 2, 2004
Operational/Managerial ControlCeo Jul 17, 2001 100%
Charlotte W Graham Individual Corporate DirectorBoard Member Feb 1, 2008 100%
Betty S Rose Individual Corporate DirectorBoard Member Jan 20, 2011 100%
James Roa Individual Corporate DirectorBoard Member Feb 1, 2008 100%
Mattie P Atkinson Individual Corporate DirectorBoard Member Feb 1, 2008 100%

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 2

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": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282176000000",
    "number": "1801911383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 SW CENTER ST",
            "city": "FAISON",
            "state": "NC",
            "postal_code": "283418820",
            "telephone_number": "910-267-0421",
            "fax_number": "910-267-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E CHARITY RD",
            "city": "ROSE HILL",
            "state": "NC",
            "postal_code": "284588303",
            "telephone_number": "910-289-3086",
            "fax_number": "910-289-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOSHEN MEDICAL CENTER INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2010-08-19",
        "status": "A",
        "authorized_official_last_name": "FUTRELL",
        "authorized_official_first_name": "REBA",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT CREDENTIALING",
        "authorized_official_telephone_number": "910-267-9997"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0122C",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344557A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plainview Health Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rose Hill, NC

Sources for this page

Verify at the official NPI Registry.