Active NPI
Carolinas Medical Center-Northeast
Doing business as Senior Care-NorthEast
- Geriatric Medicine (Internal Medicine) Physician
- Concord, NC
National Provider Identifier
1578709325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- Legal business name
- CAROLINAS MEDICAL CENTER-NORTHEAST
- 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
- Dec 29, 2008
- Organization subpart
- Yes
- Parent organization
- CAROLINAS MEDICAL CENTER-NORTHEAST
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 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 identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DF8926 | Other | NC | RAILROAD MEDICARE PTAN |
| 5950737 | Medicaid | NC |
Other names 1
- Senior Care-NorthEast
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.
-
- Internal Medicine Physician
- Concord, NC
- NPI 1740241801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230508800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1364515200000",
"number": "1578709325",
"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": "CAROLINAS MEDICAL CENTER-NORTHEAST",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CAROLINAS MEDICAL CENTER-NORTHEAST",
"enumeration_date": "2008-12-29",
"last_updated": "2013-03-29",
"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": "207RG0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Geriatric Medicine",
"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": "5950737",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Senior Care-NorthEast",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Concord, NC
- Carolinas Medical Center-Northeast (Heart Success Clinic)
- Carolinas Medical Center-Northeast (Ardsley Internal Medicine)
- Carolinas Medical Center-Northeast (NorthEast Dermatology)
- Carolinas Medical Center-Northeast (Development & Behavioral Pediatrics of the Carolina's)
- Carolinas Medical Center-Northeast (Cabarrus OB/GYN)
- Carolinas Medical Center-Northeast (Occupational Medicine Services)
- Carolinas Medical Center-Northeast (Carolinas Pediatric Neurology Care - Concord)
- Carolinas Medical Center-Northeast (Northeast Neurology)
- Carolinas Medical Center-Northeast
- Carolinas Medical Center-Northeast (Carolina Pediatric Gastroenterology)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.