NPIMap

Organization Active NPI

The Charlotte-Mecklenburg Hospital Authority

Doing business as Senior Care-NorthEast

  • Geriatric Medicine (Internal Medicine) Physician
  • Concord, NC
National Provider Identifier
1457788812
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
Doing business as
Senior Care-NorthEast
Practice address
319 Penny LN
Suite B
Concord, NC 28025-1221
Phone
(704) 403-7780
Fax
(704) 403-7781
NPI assigned
Oct 1, 2013
Last updated
Jan 21, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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) 403-1780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU Primary

Addresses

Primary practice location

319 Penny LN
Suite B
Concord, NC 28025-1221

Mailing address

319 Penny LN
Suite B
Concord, NC 28025-1221
Phone (704) 403-7780

Other names 1

  • Senior Care-NorthEast Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100309000605 NC Part B Supplier - Clinic/Group Practice 2961310685 Receives reassigned benefits from 1,831 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Carolinas Medical Center104 organizations share this tax ID, including this one
Part of
Carolinas Medical Center

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390262400000",
    "number": "1457788812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 PENNY LN",
            "address_2": "SUITE B",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251221",
            "telephone_number": "704-403-7780",
            "fax_number": "704-403-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 PENNY LN",
            "address_2": "SUITE B",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251221",
            "telephone_number": "704-403-7780",
            "fax_number": "704-403-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
        "enumeration_date": "2013-10-01",
        "last_updated": "2014-01-21",
        "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": "704-403-1780"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Senior Care-NorthEast",
            "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 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.