NPIMap

Organization Active NPI

Carolinas Medical Center-Northeast

Doing business as Kannapolis Internal Medicine

  • Internal Medicine Physician
  • Kannapolis, NC
National Provider Identifier
1689620957
Registry record updated Aug 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CAROLINAS MEDICAL CENTER-NORTHEAST
Doing business as
Kannapolis Internal Medicine
Practice address
201 Dale Earnhardt Blvd
Suite 200
Kannapolis, NC 28083-0303
Phone
(704) 932-1155
Fax
(704) 932-3500
NPI assigned
May 26, 2006
Last updated
Aug 29, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROLINAS MEDICAL CENTER-NORTHEASTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 29, 2013

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
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

201 Dale Earnhardt Blvd
Suite 200
Kannapolis, NC 28083-0303

Mailing address

201 Dale Earnhardt Blvd
Suite 200
Kannapolis, NC 28083-0303
Phone (704) 932-1155

Other identifiers 9

IdentifierTypeStateIssuer
5906968MedicaidNC
7231OtherNCPARTNERS MEDICARE CHOICE
355573OtherNCMAMSI GROUP NO
0116MOtherNCBCBS EFF PRIOR TO 7-1-07
566000156011OtherNCTRICARE STANDARD, NON NWK
890116MMedicaidNC
DF8926OtherNCRAILROAD MEDICARE PTAN
019F3OtherNCBCBS EFF 7-1-07
CC2854OtherNCRAILROAD MEDICARE GROUP

Other names 1

  • KANNAPOLIS INTERNAL MEDICINE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carolinas Medical Center104 organizations share this tax ID, including this one
Part of
CMC - Northeast Inc

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

313 Yadkin St
Albemarle, NC 28001
Phone (704) 982-2260

1045 NE Gateway Ct NE
Concord, NC 28025
Phone (704) 403-1729

1085 NE Gateway Ct NE
Ste 160
Concord, NC 28025
Phone (704) 403-8600

1085 NE Gateway Ct NE
Ste 200
Concord, NC 28025
Phone (704) 260-8650

1090 NE Gateway Ct NE
Ste 102
Concord, NC 28025
Phone (704) 403-9250

130 Lake Concord Rd NE
Concord, NC 28025
Phone (704) 788-1192

130 Lake Concord Rd NE
Ste D
Concord, NC 28025
Phone (704) 403-1136

200 Medical Park Dr
Ste 110
Concord, NC 28025
Phone (704) 403-2222

200 Medical Park Dr
Ste 500
Concord, NC 28025
Phone (704) 403-4980

301 Medical Park Dr
Ste 201
Concord, NC 28025
Phone (704) 403-7050

301 Medical Park Dr
Ste 202A
Concord, NC 28025
Phone (704) 403-2627

315 Medical Park Dr
Ste 204
Concord, NC 28025
Phone (704) 783-2068

390 Copperfield Blvd NE
Concord, NC 28025
Phone (704) 783-3564

5641 Poplar Tent Rd
Ste 102
Concord, NC 28027
Phone (704) 720-3696

845 Church St N
Ste 105
Concord, NC 28025
Phone (704) 403-7575

16623 Birkdale Commons Pkwy
Huntersville, NC 28078
Phone (704) 403-1311

340 W Jake Alexander Blvd
Southpoint Internal Medicine
Salisbury, NC 28147
Phone (704) 403-6260

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 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377734400000",
    "number": "1689620957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DALE EARNHARDT BLVD",
            "address_2": "SUITE 200",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280830303",
            "telephone_number": "704-932-1155",
            "fax_number": "704-932-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 DALE EARNHARDT BLVD",
            "address_2": "SUITE 200",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280830303",
            "telephone_number": "704-932-1155",
            "fax_number": "704-932-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS MEDICAL CENTER-NORTHEAST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS MEDICAL CENTER-NORTHEAST",
        "enumeration_date": "2006-05-26",
        "last_updated": "2013-08-29",
        "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": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906968",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MEDICARE CHOICE",
            "identifier": "7231",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI GROUP NO",
            "identifier": "355573",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS EFF PRIOR TO 7-1-07",
            "identifier": "0116M",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE STANDARD, NON NWK",
            "identifier": "566000156011",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890116M",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DF8926",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS EFF 7-1-07",
            "identifier": "019F3",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "CC2854",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KANNAPOLIS INTERNAL MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kannapolis, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.

Verify at the official NPI Registry.