Active NPI
Trevor I Goldberg, M.D.
- Otolaryngology Physician
- Charlotte, NC
National Provider Identifier
1871561746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 25026
- Practice address
- 6035 Fairview Rd
Charlotte, NC 28210-3256 - Phone
- (704) 295-3000
- Fax
- (704) 295-3468
- NPI assigned
- Mar 8, 2006
- Last updated
- Nov 18, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 25026 | NC | Primary |
Addresses
Primary practice location
6035 Fairview Rd
Charlotte, NC 28210-3256
Mailing address
6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000
Other identifiers 16
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36083 | Other | NC | BCBS |
| 4074100 | Other | NC | AETNA |
| N25026 | Medicaid | SC | |
| 20095443 | Other | SC | SELECT HEALTH OF SC |
| 776466 | Other | SC | WELLCARE |
| 1959 | Other | NC | DOCTORS HEALTH PLAN |
| 10479 | Other | NC | KANAWHA |
| 000000257626 | Other | SC | UNISON HEALTH PLAN OF SC |
| 0129451001 | Other | NC | CIGNA |
| 276569 | Other | NC | MAMSI |
| 6866 | Other | NC | PARTNERS |
| 1041431 | Other | NY | UNITED HEATHCARE |
| 11106 | Other | NC | WELLPATH |
| 8936083 | Medicaid | NC | |
| 141009 | Other | NC | COVENTRY HEALTHCARE |
| 24400 | Other | NC | MEDCOST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25026 | NC | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384732800000",
"number": "1871561746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6035 FAIRVIEW RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103256",
"telephone_number": "704-295-3000",
"fax_number": "704-295-3468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6035 FAIRVIEW RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103256",
"telephone_number": "704-295-3000",
"fax_number": "704-295-3468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "TREVOR",
"middle_name": "I",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-08",
"last_updated": "2013-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NC",
"license": "25026",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "36083",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4074100",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "N25026",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SELECT HEALTH OF SC",
"identifier": "20095443",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "776466",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DOCTORS HEALTH PLAN",
"identifier": "1959",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KANAWHA",
"identifier": "10479",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON HEALTH PLAN OF SC",
"identifier": "000000257626",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0129451001",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "276569",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "6866",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEATHCARE",
"identifier": "1041431",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLPATH",
"identifier": "11106",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8936083",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY HEALTHCARE",
"identifier": "141009",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "24400",
"state": "NC"
}
],
"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 Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.