GOSHEN MEDICAL CENTER INCORPORATED
NPI 1548711963
Clinic/Center - Federally Qualified Health Center (FQHC) in Southport, NC

Active since October 20, 2016CLIA 34D0968311 · Waiver
4654 LONG BEACH RD SE, SOUTHPORT, NC 28461(910) 457-0070 Get Directions Write a Review

NPPES record last updated: May 29, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 29, 2019, Oct 20, 2016 (2 updates tracked since 2016).

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) 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, Ceo, as its authorized official.

NPPES Registry Identity

NPI1548711963
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameGOSHEN MEDICAL CENTER INCORPORATED
Location Address4654 LONG BEACH RD SESouthport, NC 28461-8799
Mailing Address444 Sw Center StFaison, NC 28341-8820 · (910) 267-0421 · Fax (855) 996-9090
Organization SubpartNo
Authorized OfficialGreg BoundsCeo · (910) 267-1942
Enumeration DateOctober 20, 2016
Last NPPES UpdateMay 29, 20192 updates tracked since enumeration
NPI 1548711963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
4654 LONG BEACH RD SE, Southport, NC 28461

Accepted Insurance

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, NC
Active · expires Jul 8, 2027
CLIA Number34D0968311
Laboratory TypePhysician Office
Certificate Effective DateJuly 9, 2025
Certificate Expiration DateJuly 8, 2027
Laboratory DirectorCarl Danny Pate
Laboratory Phone(910) 457-0070
Laboratory LocationGoshen Medical Center Southport4654 Long Beach Road SE, Southport, NC 28461
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
4654 LONG BEACH RD SE
SOUTHPORT, NC 28461
Physician Assistant (Medical)
4654 LONG BEACH RD SE
SOUTHPORT, NC 28461
Legal Medicine
4654 LONG BEACH RD SE
SOUTHPORT, NC 28461
Clinic/Center (Urgent Care)
4654 LONG BEACH RD SE
SOUTHPORT, NC 28461

Frequently 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.

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.

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 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 May 29, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.