Active NPI
Wendell Aubrey Goins, MD
- Surgery Physician
- Charlotte, NC
National Provider Identifier
1831255009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 94-01199
- Practice address
- 9336 Blakeney Centre Dr
Ste 100B
Charlotte, NC 28277-6666 - Phone
- (704) 759-1770
- Fax
- (704) 759-1760
- NPI assigned
- Dec 29, 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 17278 | SC | |
| Surgery Physician | 208600000X | 94-01199 | NC | Primary |
Addresses
Primary practice location
9336 Blakeney Centre Dr
Ste 100B
Charlotte, NC 28277-6666
Mailing address
9336 Blakeney Centre Dr
Ste 100B
Charlotte, NC 28277-6666
Phone (704) 759-1770
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1395J | Other | NC | BLUE CROSS BLUE SHIELD |
| 172789 | Medicaid | SC | |
| 020050993 | Other | SC | RAILROAD MEDICARE |
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 Jan 1, 2018 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94-01199 | NC | MD | Surgery Physician |
| 17278 | SC | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391385600000",
"number": "1831255009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9336 BLAKENEY CENTRE DR",
"address_2": "STE 100B",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282776666",
"telephone_number": "704-759-1770",
"fax_number": "704-759-1760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9336 BLAKENEY CENTRE DR",
"address_2": "STE 100B",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282776666",
"telephone_number": "704-759-1770",
"fax_number": "704-759-1760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOINS",
"first_name": "WENDELL",
"middle_name": "AUBREY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-29",
"last_updated": "2014-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SC",
"license": "17278",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "94-01199",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "1395J",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "172789",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "020050993",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2014; 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.