Organization · Type 2 NPI

Goldsboro Pediatrics PA

Rural Health Clinic/Center · Lagrange, NC

NPI number 1497523625 Active

Practice location

114 E Railroad Street
Lagrange, NC 28551

Fax (252) 566-4430

Specialties and licenses

Taxonomy	Code	License
Pediatrics Physician	208000000X	None listed
Rural Health Clinic/Center Primary	261QR1300X	None listed

Rural Health Clinic/Center: Definition to come...

NPI record

NPI: 1497523625
Entity type: Organization (Type 2)
Issued: Dec 18, 2023
Last updated: Feb 10, 2026
Status: Active
Subpart: Yes of Goldsboro Pediatrics PA

Other names

<unavail>
Lagrange Pediatrics PA · other name
Lagrange Pediatrics PA · other name

Authorized official

Mr. Michael Allen Riddick
Practice Manager
(919) 734-4736

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1497523625

Goldsboro Pediatrics PA's National Provider Identifier is 1497523625, issued on Dec 18, 2023. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Lagrange, NC. The record was last updated on Feb 10, 2026.