NPIMap

Organization Active NPI

Carolinas Medical Center-Northeast

  • Gynecology Physician
  • Concord, NC
National Provider Identifier
1306181128
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
CAROLINAS MEDICAL CENTER-NORTHEAST
Practice address
10030 Edison Square Dr
100-A
Concord, NC 28027-8252
Phone
(704) 403-7670
Fax
(704) 403-7671
NPI assigned
Dec 5, 2012
Organization subpart
Yes
Parent organization
CAROLINAS MEDICAL CENTER-NORTHEASTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Authorized official

Name
Frieda Miller Lowder
Title
Sr Vice President
Phone
(704) 403-4146

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X Primary

Addresses

Primary practice location

10030 Edison Square Dr
100-A
Concord, NC 28027-8252

Mailing address

10030 Edison Square Dr
100-A
Concord, NC 28027-8252
Phone (704) 403-7670

Other identifiers 1

IdentifierTypeStateIssuer
5922045MedicaidNC

Other names 1

  • GYN Care of the Carolinas Doing business as

National Provider Directory

National Provider Directory
Part of
CMC Northeast

Locations

10030 Edison Square Dr NW
#100A
Concord, NC 28027
Phone (704) 403-7670

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358467200000",
    "number": "1306181128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10030 EDISON SQUARE DR",
            "address_2": "100-A",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280278252",
            "telephone_number": "704-403-7670",
            "fax_number": "704-403-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10030 EDISON SQUARE DR",
            "address_2": "100-A",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280278252",
            "telephone_number": "704-403-7670",
            "fax_number": "704-403-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS MEDICAL CENTER-NORTHEAST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS MEDICAL CENTER-NORTHEAST",
        "enumeration_date": "2012-12-05",
        "last_updated": "2013-01-18",
        "status": "A",
        "authorized_official_last_name": "LOWDER",
        "authorized_official_first_name": "FRIEDA",
        "authorized_official_middle_name": "MILLER",
        "authorized_official_title_or_position": "SR VICE PRESIDENT",
        "authorized_official_telephone_number": "704-403-4146"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5922045",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GYN Care of the Carolinas",
            "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 Jan 18, 2013; 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.