Organization Active NPI

Carolinas Medical Center-Northeast

Doing business as Northeast Neurology -Huntersville

  • Neurology Physician
  • Huntersville, NC
National Provider Identifier
1700075702
Registry record updated Mar 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
CAROLINAS MEDICAL CENTER-NORTHEAST
Doing business as
Northeast Neurology -Huntersville
Practice address
9625 Northcross Center CT
Suite 102-F
Huntersville, NC 28078-7348
Phone
(800) 230-1721
Fax
(704) 403-1901
NPI assigned
Oct 16, 2007
Last updated
Mar 25, 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 Mar 25, 2013

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)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

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

Mailing address

9625 Northcross Center CT
Suite 102-F
Huntersville, NC 28078-7348
Phone (800) 230-1721

Other identifiers 3

IdentifierTypeStateIssuer
5908519MedicaidNC
019GNOtherNCBCBSNC
DF8926OtherNCRAILROAD MEDICARE PTAN

Other names 1

  • NORTHEAST NEUROLOGY -HUNTERSVILLE Doing business as

National Provider Directory

National Provider Directory
Part of
CMC-Northeast Inc

Locations

7825 Ballantyne Commons Pkwy
Ste 110
Charlotte, NC 28277
Phone (704) 446-0391

315 Medical Park Dr
Concord, NC 28025
Phone (704) 403-4499

16645 Birkdale Commons Pkwy
Ste 200D
Huntersville, NC 28078
Phone (704) 801-1260

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.

NPI Registry JSON

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364169600000",
    "number": "1700075702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9625 NORTHCROSS CENTER CT",
            "address_2": "SUITE 102-F",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787348",
            "telephone_number": "800-230-1721",
            "fax_number": "704-403-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9625 NORTHCROSS CENTER CT",
            "address_2": "SUITE 102-F",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787348",
            "telephone_number": "800-230-1721",
            "fax_number": "704-403-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS MEDICAL CENTER-NORTHEAST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS MEDICAL CENTER-NORTHEAST",
        "enumeration_date": "2007-10-16",
        "last_updated": "2013-03-25",
        "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": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908519",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "019GN",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DF8926",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHEAST NEUROLOGY -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 Mar 25, 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.