NPIMap

Organization Active NPI

CMC-Northeast, Inc.

Doing business as NorthEast Pediatric Endocrinology-Huntersville

  • Pediatric Endocrinology Physician
  • Huntersville, NC
National Provider Identifier
1548466881
Registry record updated Aug 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
Legal business name
CMC-NORTHEAST, INC.
Doing business as
NorthEast Pediatric Endocrinology-Huntersville
Practice address
9625 Northcross Center CT
Suite 102-C
Huntersville, NC 28078-7348
Phone
(704) 801-1240
Fax
(704) 801-1240
NPI assigned
Jun 25, 2007
Last updated
Aug 21, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
CMC-NORTHEAST, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 21, 2012

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
Phone
(704) 403-4146

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X NU Primary

Addresses

Primary practice location

9625 Northcross Center CT
Suite 102-C
Huntersville, NC 28078-7348

Mailing address

9625 Northcross Center CT
Suite 102-C
Huntersville, NC 28078-7348
Phone (704) 801-1240

Other identifiers 6

IdentifierTypeStateIssuer
5914403OtherNCMEDICAID GROUP NUMBER, EFF 5/1/09
015Y2OtherNCBCBS
5906850MedicaidNC
DF8926OtherNCRAILROAD MEDICARE PTAN
355573OtherNCMAMSI
019FTOtherNCBCBS EFF 7-1-07

Other names 1

  • NorthEast Pediatric Endocrinology-Huntersville Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CMC - Northeast Inc44 organizations share this tax ID, including this one
Part of
CMC - Northeast Inc

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": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345507200000",
    "number": "1548466881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9625 NORTHCROSS CENTER CT",
            "address_2": "SUITE 102-C",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787348",
            "telephone_number": "704-801-1240",
            "fax_number": "704-801-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9625 NORTHCROSS CENTER CT",
            "address_2": "SUITE 102-C",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787348",
            "telephone_number": "704-801-1240",
            "fax_number": "704-801-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC-NORTHEAST, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CMC-NORTHEAST, INC.",
        "enumeration_date": "2007-06-25",
        "last_updated": "2012-08-21",
        "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",
        "authorized_official_telephone_number": "704-403-4146"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP NUMBER, EFF 5/1/09",
            "identifier": "5914403",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "015Y2",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906850",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DF8926",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "355573",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS EFF 7-1-07",
            "identifier": "019FT",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NorthEast 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 21, 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.