GOSHEN MEDICAL CENTER BOLTON
NPI 1164695375
Clinic/Center - Federally Qualified Health Center (FQHC) in Bolton, NC
About Goshen Medical Center Bolton NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GOSHEN MEDICAL CENTER BOLTON (NPI 1164695375) is a healthcare organization registered as a federally qualified health center (fqhc) in Bolton, North Carolina and active in the NPI registry since April 2008. The organization holds a CLIA Microscopy certificate valid through August 31, 2027 and lists Rebecca M Brown, Credentialing, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Goshen Medical Center Bolton is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
173Medicare enrollment records show 173 clinicians reassign Medicare billing to Goshen Medical Center Bolton, which bills Medicare for the services they deliver. Of these, 3 practice at this address. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 8
Nearest to this location (20)
See all 173Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 34D1051327
Goshen Medical Center - Bolton · Bolton, NCFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Goshen Medical Center Incorporated's NPI number?
The NPI number for Goshen Medical Center Incorporated is 1164695375. It was assigned to this organization in the NPPES registry on April 9, 2008. The provider is also known as Goshen Medical Center Bolton.
Where is Goshen Medical Center Incorporated located?
Goshen Medical Center Incorporated is located at 213 9th St, Bolton, NC 28423. The listed phone number is (910) 655-8300.
What is Goshen Medical Center Incorporated's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Goshen Medical Center Incorporated enrolled in Medicare?
Yes. Goshen Medical Center Incorporated is registered in the Medicare PECOS enrollment system.
When is Goshen Medical Center Incorporated's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (North Carolina, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Goshen Medical Center Incorporated?
According to the CMS Revalidation Reassignment List (October 2026 release), 173 clinicians in 8 Medicare specialties reassign their Medicare billing to Goshen Medical Center Incorporated. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (128), Family Practice (17) and Dentist (8). Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Goshen Medical Center Incorporated hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 34D1051327) is associated with this NPI, valid through August 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Goshen Medical Center Incorporated accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina and Ambetter of Tennessee list Goshen Medical Center Incorporated as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Goshen Medical Center Incorporated was last updated on February 18, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Goshen Medical Center Bolton · NPI 1164695375
Federally Qualified Health Center (FQHC) organization in Bolton, North Carolina. Organization record, active in the CMS NPPES registry since April 9, 2008.
## Identity
- **NPI:** 1164695375 (Entity type: Organization)
- **Enumerated:** April 9, 2008
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Goshen Medical Center Incorporated
- **Organization subpart:** No
- **Authorized official:** Rebecca Brown, CREDENTIALING
## Practice location
- **Address:** 213 9TH ST, Bolton, NC 28423-8410
- **Phone:** (910) 655-8300
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, North Carolina, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 173 clinicians in 8 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (128), Family Practice (17), Dentist (8); 3 practice at this address; [full list](https://npiprofile.com/npi/1164695375/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 18, 2015
- **Other identifiers:** Medicare OSCAR/certification 341940 (NC)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1164695375) · Data from the CMS NPPES public registry.