Active NPI
Mathew Gerald Wilding, D.C.
- Chiropractor
- Goldsboro, NC
National Provider Identifier
1912048018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2641
- Practice address
- 206 E Mulberry St
Goldsboro, NC 27530-3733 - Phone
- (919) 759-9177
- Fax
- (919) 759-9188
- NPI assigned
- Feb 9, 2007
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2641 | NC | Primary |
Addresses
Primary practice location
206 E Mulberry St
Goldsboro, NC 27530-3733
Mailing address
206 E Mulberry St
Goldsboro, NC 27530-3733
Phone (919) 759-9177
Other practice location 1
1006 Corporate Drive
Goldsboro, NC 27534-1608
Phone (919) 759-9177
Other practice location 2
1006 Corporate Drive
Goldsboro, NC 27534-1608
Phone (919) 759-9177
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890836H | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040915000591 | NC | Practitioner - Chiropractic | 7618943671 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2641 | NC | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| GVNR, LLC | Current | Accepting new patients |
Locations
206 E Mulberry St
Goldsboro, NC 27530
Phone (919) 738-2734
Organizations & group practices 1
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.
-
- Interventional Pain Medicine Physician
- Goldsboro, NC
- NPI 1730875444
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1912048018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 E MULBERRY ST",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275303733",
"telephone_number": "919-759-9177",
"fax_number": "919-759-9188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 E MULBERRY ST",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275303733",
"telephone_number": "919-759-9177",
"fax_number": "919-759-9188"
}
],
"practiceLocations": [
{
"address_1": "1006 Corporate Drive",
"address_purpose": "LOCATION",
"city": "Goldsboro",
"state": "NC",
"postal_code": "275341608",
"country_code": "US",
"telephone_number": "919-759-9177",
"fax_number": "919-759-9188",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1006 Corporate Drive",
"address_purpose": "LOCATION",
"city": "Goldsboro",
"state": "NC",
"postal_code": "275341608",
"country_code": "US",
"telephone_number": "919-759-9177",
"fax_number": "919-759-9188",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILDING",
"first_name": "MATHEW",
"middle_name": "GERALD",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-09",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "2641",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890836H",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Goldsboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.