GOSHEN MEDICAL CENTER INCORPORATED
NPI 1548711963
Clinic/Center - Federally Qualified Health Center (FQHC) in Southport, NC
About Goshen Medical Center Incorporated NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GOSHEN MEDICAL CENTER INCORPORATED (NPI 1548711963), doing business as Goshen Medical Center - Southport, is a healthcare organization registered as a federally qualified health center (fqhc) in Southport, North Carolina and active in the NPI registry since October 2016. The organization holds a CLIA Waiver certificate valid through July 8, 2027 and lists Greg Bounds, Executive Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 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 Incorporated 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 Incorporated, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. 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 of Waiver 34D0968311
Goshen Medical Center Southport · Southport, 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 1548711963. It was assigned to this organization in the NPPES registry on October 20, 2016. The provider is doing business as Goshen Medical Center - Southport.
Where is Goshen Medical Center Incorporated located?
Goshen Medical Center Incorporated is located at 4654 Long Beach Rd SE, Southport, NC 28461. The listed phone number is (910) 457-0070.
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, 1 practice within 10 miles. 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 of Waiver (number 34D0968311) is associated with this NPI, valid through July 8, 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 October 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 27 days 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 Incorporated · NPI 1548711963
Federally Qualified Health Center (FQHC) organization in Southport, North Carolina. Organization record, active in the CMS NPPES registry since October 20, 2016.
## Identity
- **NPI:** 1548711963 (Entity type: Organization)
- **Enumerated:** October 20, 2016
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Also known as:** Goshen Medical Center - Southport (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Greg Bounds, EXECUTIVE DIRECTOR
## Practice location
- **Address:** 4654 LONG BEACH RD SE, Southport, NC 28461-8799
- **Phone:** (910) 457-0070
## 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); 1 practice within 10 miles; [full list](https://npiprofile.com/npi/1548711963/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 7, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1548711963) · Data from the CMS NPPES public registry.