Individual provider Active NPI

Philip R Gould, M.D.

  • Internal Medicine Physician
  • Yanceyville, NC
National Provider Identifier
1821030792
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2013-00445 Issued in NC
Practice address
439 US Highway 158 W
Yanceyville, NC 27379-8304
Phone
(336) 694-9331
Fax
(336) 694-4209
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME 17023 FL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME17023 FL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2013-00445 NC
Internal Medicine Physician 207R00000X 2013-00445 NC Primary

Addresses

Primary practice location

439 US Highway 158 W
Yanceyville, NC 27379-8304

Mailing address

439 US Highway 158 W
Yanceyville, NC 27379-8304
Phone (336) 694-9331

Other practice location 1

10130 Perimeter Pkwy Ste 200
Charlotte, NC 28216-0197
Phone (888) 849-7379

Other identifiers 2

IdentifierTypeStateIssuer
19BMROtherNCBCBSNC
1821030792MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150115001527 NC Practitioner - Internal Medicine 9638327778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio State University College of Medicine, 1964
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goshen Medical Center IncorporatedGroup PAC ID 3173434479, 96 clinicians

Practice addresses (Care Compare)

444 SW Ctr St
Faison, NC 28341-8820
Phone (910) 267-0421

460 SW Ctr St
Faison, NC 28341-8820
Phone (910) 267-0951

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 Medicine

State licenses

LicenseStateTypeSpecialty
ME 17023FLMDInternal Medicine Physician
2013-00445NCMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Medical Center, Incorporated Current Accepting new patients
Goshen Medical Center Incorporated CurrentSince Apr 17, 2017 Accepting new patients
Goshen Medical Center Incorporated CurrentSince Apr 17, 2017 Accepting new patients
Goshen Medical Center Incorporated Past Accepting new patients
Goshen Medical Center Incorporated Past Accepting new patients
Goshen Medical Center, Incorporated Past Accepting new patients

Locations

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

104A Adair Dr
Goldsboro, NC 27530
Phone (919) 648-4435

106 Jefferson St
Hamlet, NC 28345
Phone (910) 557-9447

811 E US Highway 74
Rockingham, NC 28379
Phone (910) 342-8796

Interoperability endpoints

  • Direct secure messaging: pgould@goshenmedical.cloudcraftdirect.com

Organizations & group practices 6

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1821030792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 US HIGHWAY 158 W",
            "city": "YANCEYVILLE",
            "state": "NC",
            "postal_code": "273798304",
            "telephone_number": "336-694-9331",
            "fax_number": "336-694-4209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 US HIGHWAY 158 W",
            "city": "YANCEYVILLE",
            "state": "NC",
            "postal_code": "273798304",
            "telephone_number": "336-694-9331",
            "fax_number": "336-694-4209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10130 Perimeter Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282160197",
            "country_code": "US",
            "telephone_number": "888-849-7379",
            "fax_number": "855-857-7333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOULD",
        "first_name": "PHILIP",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 17023",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME17023",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "2013-00445",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2013-00445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "19BMR",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821030792",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yanceyville, NC

Sources for this page

Verify at the official NPI Registry.