NPIMap

Organization Active NPI

CMC-Northeast, Inc.

  • Pediatrics Physician
  • Harrisburg, NC
National Provider Identifier
1407086093
Registry record updated Jun 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CMC-NORTHEAST, INC.
Practice address
5427 Highway 49 S
Rocky River Pediatrics
Harrisburg, NC 28075-7408
Phone
(704) 455-5565
Fax
(704) 455-6225
NPI assigned
Jul 17, 2009
Organization subpart
Yes
Parent organization
CMC-NORTHEAST, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2010

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

5427 Highway 49 S
Rocky River Pediatrics
Harrisburg, NC 28075-7408

Mailing address

5427 Highway 49 S
Harrisburg, NC 28075-7408
Phone (704) 455-5565

Other identifiers 2

IdentifierTypeStateIssuer
DF8926OtherNCRAILROAD MEDICARE PTAN
5906981MedicaidNC

Other names 1

  • Rocky River Pediatrics 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

Locations

2608 E 7th St
Ste B
Charlotte, NC 28204
Phone (704) 403-2626

NPI Registry JSON

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275350400000",
    "number": "1407086093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5427 HIGHWAY 49 S",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280757408",
            "telephone_number": "704-455-5565",
            "fax_number": "704-455-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5427 HIGHWAY 49 S",
            "address_2": "ROCKY RIVER PEDIATRICS",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280757408",
            "telephone_number": "704-455-5565",
            "fax_number": "704-455-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC-NORTHEAST, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CMC-NORTHEAST, INC.",
        "enumeration_date": "2009-07-17",
        "last_updated": "2010-06-01",
        "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": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DF8926",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906981",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rocky River Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrisburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; 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.