NPIMap

Organization Active NPI

CMC-Northeast, Inc.

Doing business as Carolinas Pediatric Neurology Care - Shelby

  • Neurology with Special Qualifications in Child Neurology Physician
  • Shelby, NC
National Provider Identifier
1144535386
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
Legal business name
CMC-NORTHEAST, INC.
Doing business as
Carolinas Pediatric Neurology Care - Shelby
Practice address
709 N Dekalb St
Carolinas Pediatric Neurology Care - Shelby
Shelby, NC 28150-3911
Phone
(704) 446-1900
Fax
(704) 446-6255
NPI assigned
Aug 12, 2010
Last updated
Nov 15, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
CMC-NORTHEAST, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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

Authorized official

Name
Frieda M Lowder
Title
Sr VP
Phone
(704) 403-4146

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0402X Primary

Addresses

Primary practice location

709 N Dekalb St
Carolinas Pediatric Neurology Care - Shelby
Shelby, NC 28150-3911

Mailing address

709 N Dekalb St
Carolinas Pediatric Neurology Care - Shelby
Shelby, NC 28150-3911
Phone (704) 446-1900

Other identifiers 2

IdentifierTypeStateIssuer
5916241MedicaidNC
NPB455MedicaidSC

Other names 1

  • Carolinas Pediatric Neurology Care - Shelby Doing business as

National Provider Directory

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

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": "1281571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1144535386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 N DEKALB ST",
            "address_2": "CAROLINAS PEDIATRIC NEUROLOGY CARE - SHELBY",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503911",
            "telephone_number": "704-446-1900",
            "fax_number": "704-446-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 N DEKALB ST",
            "address_2": "CAROLINAS PEDIATRIC NEUROLOGY CARE - SHELBY",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503911",
            "telephone_number": "704-446-1900",
            "fax_number": "704-446-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC-NORTHEAST, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CMC-NORTHEAST, INC.",
        "enumeration_date": "2010-08-12",
        "last_updated": "2011-11-15",
        "status": "A",
        "authorized_official_last_name": "LOWDER",
        "authorized_official_first_name": "FRIEDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR VP",
        "authorized_official_telephone_number": "704-403-4146"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5916241",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPB455",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolinas Pediatric Neurology Care - Shelby",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; 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.