NPIMap

Organization Active NPI

CMC-Northeast, Inc.

Doing business as Carolinas Pediatric Neurology Care - Gastonia

  • Neurology with Special Qualifications in Child Neurology Physician
  • Gastonia, NC
National Provider Identifier
1174823900
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 - Gastonia
Practice address
2550 Court Dr
Suite 203
Gastonia, NC 28054-2152
Phone
(704) 403-2660
Fax
(704) 403-2670
NPI assigned
Oct 27, 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. Vice President
Phone
(704) 403-4146

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X NU Primary

Addresses

Primary practice location

2550 Court Dr
Suite 203
Gastonia, NC 28054-2152

Mailing address

2550 Court Dr
Suite 203
Gastonia, NC 28054-2152
Phone (704) 403-2660

Other identifiers 2

IdentifierTypeStateIssuer
5916350MedicaidNC
NPB455MedicaidSC

Other names 1

  • Carolinas Pediatric Neurology Care - Gastonia 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": "1288137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1174823900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 COURT DR",
            "address_2": "SUITE 203",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542152",
            "telephone_number": "704-403-2660",
            "fax_number": "704-403-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 COURT DR",
            "address_2": "SUITE 203",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542152",
            "telephone_number": "704-403-2660",
            "fax_number": "704-403-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC-NORTHEAST, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CMC-NORTHEAST, INC.",
        "enumeration_date": "2010-10-27",
        "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. VICE PRESIDENT",
        "authorized_official_telephone_number": "704-403-4146"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5916350",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPB455",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolinas Pediatric Neurology Care - Gastonia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gastonia, 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.