NPIMap

Organization Active NPI

Goshen Medical Center, Incorporated

Doing business as Goshen Medical Center - Albemarle

  • Federally Qualified Health Center (FQHC)
  • Albemarle, NC
National Provider Identifier
1982371514
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GOSHEN MEDICAL CENTER, INCORPORATED
Doing business as
Goshen Medical Center - Albemarle
Practice address
1000 N 5TH St
Albemarle, NC 28001-3420
Phone
(910) 267-0421
Fax
(704) 235-1992
NPI assigned
Aug 23, 2021
Last updated
Jun 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Authorized official

Name
Gregory M Bounds
Title
Ceo
Phone
(910) 267-0421

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1000 N 5TH St
Albemarle, NC 28001-3420

Mailing address

PO Box 187
Faison, NC 28341-0187
Phone (910) 267-2042

Other names 1

  • Goshen Medical Center - Albemarle Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040102000726 NC Part B Supplier - Clinic/Group Practice 3173434479 Receives reassigned benefits from 224 practitioners
45 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kenansville, NC; Morehead City, NC; Mount Olive, NC; New Bern, NC; Rockingham, NC; Rose Hill, NC; Sanford, NC; Southport, NC…
O20211007001308 NC Part A Provider - Federally Qualified Health Center (FQHC) 3173434479 Practice locations: Albemarle, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982371514. Details of each certification follow.

Federally qualified health center certification: CCN 861813

Legal name
GOSHEN MEDICAL CENTER INCORPORATED
Doing business as
GOSHEN MEDICAL CENTER - ALBEMARLE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 1, 2021
Last certification
Aug 1, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationProprietary
Incorporated
May 29, 1979 in NC
Enrollment address
1000 N 5TH St
Albemarle, NC 28001-3420

Other NPIs on the same Medicare enrollment 44

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 44

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Rhonda Barwick Individual Corporate OfficerDirector of Operations Feb 1, 2017
W-2 Managing EmployeeDirector of Operations Feb 1, 2017
Operational/Managerial ControlDirector of Operations Feb 1, 2017
Mary Mayeau Individual Corporate OfficerBoard Member Jan 1, 2016
Gregory M Bounds Individual Corporate OfficerCeo Jan 2, 2004
W-2 Managing EmployeeCeo Jan 2, 2004
Operational/Managerial ControlCeo Jan 2, 2004

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Goshen Medical Center-Whiteville Mobile UnitWhiteville, NC, CCN 341007 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2012
Goshen Medical Center-Cape FearFayetteville, NC, CCN 341012 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 1, 2014
Goshen Medical Center-New BernNew Bern, NC, CCN 341022 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 25, 2014
Goshen Medical Center-FairviewClinton, NC, CCN 341019 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2014
Goshen Medical Center - DunnDunn, NC, CCN 341083 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 4, 2017
Goshen Medical Center - New BernNew Bern, NC, CCN B61075 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 2, 2025
Goshen Medical Center - WilmingtonWilmington, NC, CCN B61090 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 29, 1979

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654214400000",
    "number": "1982371514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 187",
            "city": "FAISON",
            "state": "NC",
            "postal_code": "283410187",
            "telephone_number": "910-267-2042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N 5TH ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013420",
            "telephone_number": "910-267-0421",
            "fax_number": "704-235-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOSHEN MEDICAL CENTER, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-23",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A",
        "authorized_official_last_name": "BOUNDS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-267-0421"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goshen Medical Center - Albemarle",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Goshen Medical Center - Albemarle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albemarle, NC

Sources for this page

Verify at the official NPI Registry.