NPIMap

Organization Active NPI

Goshen Medical Center, Incorporated

Doing business as Goshen Medical Center - Fayetteville

  • Federally Qualified Health Center (FQHC)
  • Fayetteville, NC
National Provider Identifier
1902474547
Registry record updated May 13, 2026
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
Doing business as
Goshen Medical Center - Fayetteville
Practice address
911 Hay St
Fayetteville, NC 28305-5313
Phone
(910) 486-6818
Fax
(910) 302-5464
NPI assigned
Jun 10, 2021
Last updated
May 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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 1

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

Addresses

Primary practice location

911 Hay St
Fayetteville, NC 28305-5313

Mailing address

PO Box 187
Faison, NC 28341-0187
Phone (910) 267-2042

Other names 1

  • Goshen Medical Center - Fayetteville 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…
O20210707001243 NC Part A Provider - Federally Qualified Health Center (FQHC) 3173434479 Practice locations: Fayetteville, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902474547. Details of each certification follow.

Federally qualified health center certification: CCN 341171

Legal name
GOSHEN MEDICAL CENTER INCORPORATED
Doing business as
GOSHEN MEDICAL CENTER-FAYETTEVILLE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 8, 2021
Last certification
Jun 8, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 29, 1979 in NC
Enrollment address
911 Hay St
Fayetteville, NC 28305-5313

Other NPIs on the same Medicare enrollment 44

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

View all 44

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0923898Goshen Medical Center - Fayetteville911 Hay Street, Fayetteville, NC 28305Certificate of waiverMay 14, 2027

National Provider Directory

National Provider Directory

Locations

1248 Fort Bragg Rd
Ste 200
Fayetteville, NC 28305
Phone (910) 339-2121

Ownership & related parties

All disclosed owners & managing parties 11

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 OfficerDirector of Operations Feb 1, 2017
W-2 Managing EmployeeDirector of Operations Feb 1, 2017
Operational/Managerial ControlDirector of Operations Feb 1, 2017
Chester Aycock Individual Corporate DirectorBoard Member Feb 1, 2008
Tanty Freeman Individual Corporate DirectorBoard Member Feb 1, 2008
Patricia a Davis Individual Corporate DirectorBoard Member Feb 1, 2008
Gregory M Bounds Individual Corporate OfficerCeo Jan 2, 2004
W-2 Managing EmployeeCeo Jan 2, 2004
Operational/Managerial ControlCeo Jan 2, 2004
Melba Harrell Individual OtherBoard Member May 1, 2023 100%
Sybil Merkison Individual OtherBoard Member May 1, 2023 100%
Diane H Graham Individual Corporate DirectorBoard Member Feb 1, 2008
Emma Brinson Individual OtherBoard Member May 1, 2024 100%
James Roa Individual Corporate DirectorBoard Member Feb 1, 2008
Mattie P Atkinson Individual Corporate DirectorBoard Member Feb 1, 2008

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": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1902474547",
    "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": "910-267-2042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 HAY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055313",
            "telephone_number": "910-486-6818",
            "fax_number": "910-302-5464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOSHEN MEDICAL CENTER, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-10",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "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": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goshen Medical Center - Fayetteville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.