GOSHEN MEDICAL CENTER WALLACE
NPI 1912022369
Clinic/Center - Federally Qualified Health Center (FQHC) in Wallace, NC
About Goshen Medical Center Wallace NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GOSHEN MEDICAL CENTER WALLACE (NPI 1912022369) is a healthcare organization registered as a federally qualified health center (fqhc) in Wallace, North Carolina and active in the NPI registry since March 2007. The organization lists Reba W. Futrell, Executive Assistant/credentialing, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 2
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 Wallace 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 Wallace, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 7 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.
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 1912022369. It was assigned to this organization in the NPPES registry on March 21, 2007. The provider is also known as Goshen Medical Center Wallace.
Where is Goshen Medical Center Incorporated located?
Goshen Medical Center Incorporated is located at 110 Eastwood Drive, Wallace, NC 28466. The listed phone number is (910) 285-2330.
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, 6 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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 Wallace · NPI 1912022369
Federally Qualified Health Center (FQHC) organization in Wallace, North Carolina. Organization record, active in the CMS NPPES registry since March 21, 2007.
## Identity
- **NPI:** 1912022369 (Entity type: Organization)
- **Enumerated:** March 21, 2007
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Goshen Medical Center Incorporated
- **Organization subpart:** No
- **Authorized official:** Reba Futrell, EXECUTIVE ASSISTANT/CREDENTIALING
## Practice location
- **Address:** 110 EASTWOOD DRIVE, Wallace, NC 28466-9236
- **Phone:** (910) 285-2330 · **Fax:** (910) 285-3060
## 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); 6 practice at this address and 7 within 10 miles; [full list](https://npiprofile.com/npi/1912022369/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 6, 2012
- **Other identifiers:** Medicaid 344011A (NC); Medicare OSCAR/certification 341910 (NC)
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Source: [NPI Profile](https://npiprofile.com/npi/1912022369) · Data from the CMS NPPES public registry.