Individual provider Active NPI

Laurie O Goss, MD

  • Pediatrics Physician
  • Matthews, NC
National Provider Identifier
1972522886
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
200400036 Issued in NC
Practice address
1401 Matthews Township Pkwy
Suite 100
Matthews, NC 28105-5402
Phone
(704) 384-1080
Fax
(704) 384-1122
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 200400036 NC Primary

Addresses

Primary practice location

1401 Matthews Township Pkwy
Suite 100
Matthews, NC 28105-5402

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-1080

Other identifiers 3

IdentifierTypeStateIssuer
N0003DMedicaidSC
5901574MedicaidNC
140JTOtherNCBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lgoss14524@direct.novanthealth.org

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
I20050825001055 NC Practitioner - Pediatric Medicine 0749211001 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group LLC Pediatrics CurrentSince May 20, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 20, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

517 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 384-1406

1401 Matthews Township Pkwy
Ste 100
Matthews, NC 28105
Phone (704) 384-1080

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1972522886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-1080",
            "fax_number": "704-384-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MATTHEWS TOWNSHIP PKWY",
            "address_2": "SUITE 100",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055402",
            "telephone_number": "704-384-1080",
            "fax_number": "704-384-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSS",
        "first_name": "LAURIE",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200400036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N0003D",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901574",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "140JT",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgoss14524@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1401 Matthews Township Pkwy",
            "address_2": "Suite 100",
            "city": "Matthews",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281055402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.