NPIMap

Organization Active NPI

Goldsboro Skin Center PA

  • Dermatology Physician
  • Goldsboro, NC
National Provider Identifier
1972567634
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
27212 Issued in NC
Legal business name
GOLDSBORO SKIN CENTER PA
Practice address
2613 Hospital Rd
Goldsboro, NC 27534-9424
Phone
(919) 736-0222
Fax
(919) 736-0223
NPI assigned
Apr 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. John L Jennings Jr., MD
Title
President
Phone
(919) 736-0222

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X 27212 NC Primary
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X 27212 NC
Procedural Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207NS0135X 27212 NC

Addresses

Primary practice location

2613 Hospital Rd
Goldsboro, NC 27534-9424

Mailing address

2613 Hospital Rd
Goldsboro, NC 27534-9424
Phone (919) 736-0222

Other identifiers 1

IdentifierTypeStateIssuer
89012KTMedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1972567634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2613 HOSPITAL RD",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349424",
            "telephone_number": "919-736-0222",
            "fax_number": "919-736-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2613 HOSPITAL RD",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349424",
            "telephone_number": "919-736-0222",
            "fax_number": "919-736-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDSBORO SKIN CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-736-0222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "NC",
            "license": "27212",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "NC",
            "license": "27212",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NC",
            "license": "27212",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89012KT",
            "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 Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.