Individual provider Active NPI

Kenton Bing-Hock Goh, MD

  • Emergency Medicine Physician
  • Bonners Ferry, ID
National Provider Identifier
1972547172
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
24216 Issued in TN
Practice address
6640 Kaniksu St
Bonners Ferry, ID 83805-7532
Phone
(208) 267-3141
Fax
(208) 267-2202
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 24216 TN Primary
Emergency Medicine Physician 207P00000X M-11866 ID

Addresses

Primary practice location

6640 Kaniksu St
Bonners Ferry, ID 83805-7532

Mailing address

6640 Kaniksu St
Bonners Ferry, ID 83805-7532
Phone (208) 267-3141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20040528000446 TN Practitioner - Emergency Medicine 1658352224 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Kentucky College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tri-Cities Regional Emergency Physicians, PCGroup PAC ID 3678859477, 118 clinicians

Practice addresses (Care Compare)

1519 Main St
Sneedville, TN 37869-3657
Phone (423) 787-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-11866IDMDEmergency Medicine Physician
24216TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities Regional Emergency Physicians, PC Emergency Medicine CurrentSince Jun 25, 2021 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Jun 15, 2015 Accepting new patients
Wellmont Medical Associates Inc CurrentSince Jun 15, 2015 Accepting new patients
Emergency Care Physicians, Inc. Emergency Medicine Past Accepting new patients
Emergency Coverage, LLC Emergency Medicine Past Accepting new patients

Locations

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000

401 Takoma Ave
Greeneville, TN 37743
Phone (423) 639-3151

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

1519 Main St
Sneedville, TN 37869
Phone (423) 733-5000

310 3rd St NE
Norton, VA 24273
Phone (276) 679-9116

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1972547172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6640 KANIKSU ST",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "838057532",
            "telephone_number": "208-267-3141",
            "fax_number": "208-267-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6640 KANIKSU ST",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "838057532",
            "telephone_number": "208-267-3141",
            "fax_number": "208-267-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOH",
        "first_name": "KENTON",
        "middle_name": "BING-HOCK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "24216",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M-11866",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonners Ferry, ID

Sources for this page

Verify at the official NPI Registry.