Northeast Medical Center

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

173393 Issued in NC

Legal business name

NORTHEAST MEDICAL CENTER

Practice address

920 Church St
Concord, NC 28075

Phone

(704) 783-1622

NPI assigned

Jul 26, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Lynn Zoba, CRNA

Title

Nurse Anesthetist

Phone

(704) 783-1622

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194748525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12729 KANE ALEXANDER DR",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280783775",
            "telephone_number": "704-992-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 CHURCH ST",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "28075",
            "telephone_number": "704-783-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZOBA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "NURSE ANESTHETIST",
        "authorized_official_telephone_number": "704-783-1622",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "173393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8051934",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Carolina CVS Pharmacy, L.L.C.
• Avery Brooke North, PHARMD
• James Hugh North Jr., M.D.
• Northeast Anesthesia and Pain Specialists PA
• Northeast Eye Center PA
• Northeast OBGYN Associates PA
• Northeast Orthopedics PA
• Northeast Surgical Specialties, LLC
• Northeast Surgical Specialties, LLC
• Northeast Surgical Specialties, LLC

• All providers in Concord, NC
• Certified Registered Nurse Anesthetist in North Carolina

• 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.