NPIMap

Organization Active NPI

CMC - Northeast, Inc.

Doing business as Northeast Internal Medicine

  • Internal Medicine Physician
  • Concord, NC
National Provider Identifier
1093762627
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CMC - NORTHEAST, INC.
Doing business as
Northeast Internal Medicine
Practice address
130 Lake Concord Rd NE
Suite B NE Internal Medicine
Concord, NC 28025-1918
Phone
(704) 652-7270
Fax
(704) 788-1935
NPI assigned
May 28, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Frieda M Lowder
Title
VP Physician Services
Phone
(704) 783-4146

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

130 Lake Concord Rd NE
Suite B NE Internal Medicine
Concord, NC 28025-1918

Mailing address

130 Lake Concord Rd NE
Suite B NE Internal Medicine
Concord, NC 28025-1918
Phone (704) 652-7270

Other identifiers 6

IdentifierTypeStateIssuer
566000156041OtherNCTRICARE STANDARD, NON NWK
F158OtherNCPARTNERS MEDICARE CHOICE
355573OtherNCMAMSI
89011XFMedicaidNC
CC2854OtherNCRAILROAD MEDICARE
011XFOtherNCBCBS GROUP ID

Other names 1

  • NORTHEAST INTERNAL MEDICINE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CMC-Northeast Inc44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093762627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 LAKE CONCORD RD NE",
            "address_2": "SUITE B NE INTERNAL MEDICINE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251918",
            "telephone_number": "704-652-7270",
            "fax_number": "704-788-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LAKE CONCORD RD NE",
            "address_2": "SUITE B NE INTERNAL MEDICINE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251918",
            "telephone_number": "704-652-7270",
            "fax_number": "704-788-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC - NORTHEAST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOWDER",
        "authorized_official_first_name": "FRIEDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VP PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "704-783-4146"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE STANDARD, NON NWK",
            "identifier": "566000156041",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MEDICARE CHOICE",
            "identifier": "F158",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "355573",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89011XF",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC2854",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP ID",
            "identifier": "011XF",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHEAST INTERNAL MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.