Carolinas Medical Center-Northeast

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

CAROLINAS MEDICAL CENTER-NORTHEAST

Doing business as

NorthEast Plastic & Reconstructive Surgery-Albemarle

Practice address

105 Yadkin Street
Suite 203
Albemarle, NC 28001-3459

Phone

(704) 403-2760

Fax

(704) 403-2779

NPI assigned

Mar 30, 2012

Last updated

Jul 12, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

CAROLINAS MEDICAL CENTER-NORTHEASTAs reported in NPPES

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

Addresses

Other identifiers 2

Other names 1

• NorthEast Plastic & Reconstructive Surgery-Albemarle Doing business as

Part of

CMC-Northeast Inc

Locations

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.

• Carolinas Medical Center-Northeast

  • Internal Medicine Physician
  • Concord, NC
  • NPI 1740241801
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Walter Lee Fanning Jr., M.D.

  • Infectious Disease Physician
  • Concord, NC
  • NPI 1639146780
  NPD (past)
• Robert Moser, MD

  • Internal Medicine Physician
  • Kannapolis, NC
  • NPI 1023080934
  NPD (past)

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342051200000",
    "number": "1376819649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 YADKIN STREET",
            "address_2": "SUITE 203",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013459",
            "telephone_number": "704-403-2760",
            "fax_number": "704-403-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 YADKIN STREET",
            "address_2": "SUITE 203",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013459",
            "telephone_number": "704-403-2760",
            "fax_number": "704-403-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS MEDICAL CENTER-NORTHEAST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS MEDICAL CENTER-NORTHEAST",
        "enumeration_date": "2012-03-30",
        "last_updated": "2012-07-12",
        "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": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5920089",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN, GROUP",
            "identifier": "232009",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NorthEast Plastic & Reconstructive Surgery-Albemarle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carolina Hearing Group Inc
• Carolina Women's Wellness Center
• Carolinas Hometown Respiratory LLC
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• Carolinas Medical Center at Home, LLC (Atrium Health At Home HME Stanly)
• Carolinas Physician Network Inc (Stanly Central Lab)
• Carolinas Physician Network Inc (Atrium Health Levine Children's Arboretum Pediatrics)
• Carolinas Physicians Network Inc (The Sanger Clinic)
• Carolinas Physicians Network Inc (Atrium Health Women's Care Stanly OB/GYN)
• Carolinas Physicians Network Inc (Atrium Health Gastroenterology & Hepatology)

• Plastic and Reconstructive Surgery Physician in Albemarle, NC
• Providers in Albemarle, NC by specialty
• Plastic and Reconstructive Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; 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.