Individual provider Active NPI

Edwin William Hoeper, MD

  • Psychiatry Physician
  • Goldsboro, NC
National Provider Identifier
1962537712
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
32513 Issued in NC
Practice address
1506 Wayne Memorial Dr
Suite H
Goldsboro, NC 27534-2202
Phone
(919) 736-4722
Fax
(919) 734-3442
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 32513 NC Primary

Addresses

Primary practice location

1506 Wayne Memorial Dr
Suite H
Goldsboro, NC 27534-2202

Mailing address

1506 Wayne Memorial Dr
Suite H
Goldsboro, NC 27534-2202
Phone (919) 736-4722

Other identifiers 1

IdentifierTypeStateIssuer
8942825MedicaidNC

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
I20120118000788 NC Practitioner - Psychiatry 5890747638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Northwestern University Feinberg Medical School, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1506 Wayne Memorial Dr
Suite H
Goldsboro, NC 27534-2202
Phone (919) 736-4722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32513NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Goldsboro Psychiatric Clinic PA Psychiatry CurrentSince Jan 1, 2003 Accepting new patients

Locations

1506 Wayne Memorial Dr
Ste H
Goldsboro, NC 27534
Phone (919) 736-4722

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962537712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 WAYNE MEMORIAL DR",
            "address_2": "SUITE H",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275342202",
            "telephone_number": "919-736-4722",
            "fax_number": "919-734-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 WAYNE MEMORIAL DR",
            "address_2": "SUITE H",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275342202",
            "telephone_number": "919-736-4722",
            "fax_number": "919-734-3442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOEPER",
        "first_name": "EDWIN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "32513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8942825",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

Verify at the official NPI Registry.