CMC-Northeast, Inc.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

CMC-NORTHEAST, INC.

Doing business as

NorthEast Plastic & Reconstructive Surgery

Practice address

200 Medical Park Dr
Suite 520
Concord, NC 28025-2982

Phone

(704) 403-2760

Fax

(704) 403-2779

NPI assigned

Apr 1, 2009

Last updated

Jun 1, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

CMC - NORTHEAST, INC.As reported in NPPES

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

Addresses

Other identifiers 2

Other names 1

• NorthEast Plastic & Reconstructive Surgery Doing business as

Part of

CMC RX Pavilion

Locations

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275350400000",
    "number": "1619119906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK DR",
            "address_2": "SUITE 520",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252982",
            "telephone_number": "704-403-2760",
            "fax_number": "704-403-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK DR",
            "address_2": "SUITE 520",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252982",
            "telephone_number": "704-403-2760",
            "fax_number": "704-403-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC-NORTHEAST, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CMC - NORTHEAST, INC.",
        "enumeration_date": "2009-04-01",
        "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": "VP PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "704-403-4146"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "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": "5911740",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NorthEast Plastic & Reconstructive Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• CMC-Northeast, Inc. (Piedmont Pediatrics)
• CMC-Northeast, Inc. (Copperfield Internal Medicine)
• CMC-Northeast, Inc. (Northeast Critical Care Associates)
• CMC-Northeast, Inc. (Northeast Inpatient Services)
• CMC-Northeast, Inc. (Carolina Pediatric Surgery)
• CMC-Northeast, Inc. (NorthEast Pediatric Pulmonology)
• CMC-Northeast, Inc. (Concord Internal Medicine)
• CMC-Northeast, Inc. (NorthEast Psychiatric Services)

• Plastic and Reconstructive Surgery Physician in Concord, NC
• Providers in Concord, NC by specialty
• Plastic and Reconstructive Surgery Physician in North Carolina

• 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.