NPIMap

Organization Active NPI

Carolinas Medical Center-Northeast

Doing business as Heart Success Clinic

  • Cardiovascular Disease Physician
  • Concord, NC
National Provider Identifier
1437425709
Registry record updated Jul 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CAROLINAS MEDICAL CENTER-NORTHEAST
Doing business as
Heart Success Clinic
Practice address
1090 Northeast Gateway Court, NE
Suite 101
Concord, NC 28025-2424
Phone
(704) 403-9177
Fax
(704) 403-9178
NPI assigned
Mar 30, 2012
Organization subpart
Yes
Parent organization
CAROLINAS MEDICAL CENTER-NORTHEASTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 12, 2012

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

1090 Northeast Gateway Court, NE
Suite 101
Concord, NC 28025-2424

Mailing address

1090 Northeast Gateway Court, NE
Suite 101
Concord, NC 28025-2424
Phone (704) 403-9177

Other identifiers 2

IdentifierTypeStateIssuer
232009OtherNCMEDICARE PTAN, GROUP
5920091MedicaidNC

Other names 1

  • Heart Success Clinic Doing business as

National Provider Directory

National Provider Directory
Part of
CMC Northeast

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.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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": "1437425709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 NORTHEAST GATEWAY COURT, NE",
            "address_2": "SUITE 101",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252424",
            "telephone_number": "704-403-9177",
            "fax_number": "704-403-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 NORTHEAST GATEWAY COURT, NE",
            "address_2": "SUITE 101",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252424",
            "telephone_number": "704-403-9177",
            "fax_number": "704-403-9178"
        }
    ],
    "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": "M",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "704-403-4146"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN, GROUP",
            "identifier": "232009",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5920091",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heart Success Clinic",
            "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 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.