NPIMap

Organization Active NPI

CMC-Northeast, Inc

  • Pediatric Endocrinology Physician
  • Huntersville, NC
National Provider Identifier
1376696062
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
Legal business name
CMC-NORTHEAST, INC
Doing business as
NE Pediatric Endocrinology, Huntersville
Practice address
16623 Birkdale CMNS Pkwy
Suite 110, NE Pediatric Endo
Huntersville, NC 28078-5621
Phone
(704) 987-4277
Fax
(704) 987-5096
NPI assigned
Jan 18, 2007
Organization subpart
Yes
Parent organization
CMC-NORTHEAST,INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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 Coord
Phone
(704) 783-4146

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0205X Primary

Addresses

Primary practice location

16623 Birkdale CMNS Pkwy
Suite 110, NE Pediatric Endo
Huntersville, NC 28078-5621

Mailing address

16623 Birkdale CMNS Pkwy
Suite 110, NE Pediatric Endo
Huntersville, NC 28078-5621
Phone (704) 987-4277

Other identifiers 6

IdentifierTypeStateIssuer
I902OtherNCPARTNERS MEDICARE CHOICE
355573OtherNCMAMSI
5903854MedicaidNC
566000156074OtherNCTRICARE STANDARD, NON NWK
015Y2OtherNCBCBS GROUP ID
4462028OtherNCAETNA

Other names 1

  • NE Pediatric Endocrinology, Huntersville Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CMC Northeast44 organizations share this tax ID, including this one
Part of
CMC Northeast

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": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1376696062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16623 BIRKDALE CMNS PKWY",
            "address_2": "SUITE 110, NE PEDIATRIC ENDO",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785621",
            "telephone_number": "704-987-4277",
            "fax_number": "704-987-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16623 BIRKDALE CMNS PKWY",
            "address_2": "SUITE 110, NE PEDIATRIC ENDO",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785621",
            "telephone_number": "704-987-4277",
            "fax_number": "704-987-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC-NORTHEAST, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CMC-NORTHEAST,INC",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-08-22",
        "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 COORD",
        "authorized_official_telephone_number": "704-783-4146"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MEDICARE CHOICE",
            "identifier": "I902",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "355573",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903854",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE STANDARD, NON NWK",
            "identifier": "566000156074",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP ID",
            "identifier": "015Y2",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4462028",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NE Pediatric Endocrinology, Huntersville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.