Organization Active NPI

CMC-Northeast, Inc.

Doing business as Concord Internal Medicine

  • Internal Medicine Physician
  • Concord, NC
National Provider Identifier
1730128810
Registry record updated Jun 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CMC-NORTHEAST, INC.
Doing business as
Concord Internal Medicine
Practice address
200 Medical Park Dr
Suite 550 Concord Internal Medicine
Concord, NC 28025-0926
Phone
(704) 403-1307
Fax
(704) 403-1090
NPI assigned
Jun 5, 2006
Last updated
Jun 1, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
CMC-NORTHEAST, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2010

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Pulmonary Disease Physician 207RP1001X NU

Addresses

Primary practice location

200 Medical Park Dr
Suite 550 Concord Internal Medicine
Concord, NC 28025-0926

Mailing address

200 Medical Park Dr
Suite 550 Concord Internal Medicine
Concord, NC 28025-0926
Phone (704) 403-1307

Other identifiers 9

IdentifierTypeStateIssuer
355573OtherNCMAMSI GROUP NUMBER
019FPOtherNCBCBS EFF 7-1-07
CC2854OtherNCRAILROAD MEDICARE GROUP
566000156022OtherNCTRICARE STANDARD, NON NWK
5906973MedicaidNC
890279NMedicaidNC
0279NOtherNCBCBS EFF PRIOR TO 7-1-07
7232OtherNCPARTNERS MEDICARE CHOICE
DF8926OtherNCRAILROAD MEDICARE PTAN

Other names 1

  • Concord Internal Medicine Doing business as

National Provider Directory

National Provider Directory
Part of
CMC - Northeast Inc

Locations

200 Medical Park Dr
Ste 550
Concord, NC 28025
Phone (704) 403-1300

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275350400000",
    "number": "1730128810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK DR",
            "address_2": "SUITE 550 CONCORD INTERNAL MEDICINE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280250926",
            "telephone_number": "704-403-1307",
            "fax_number": "704-403-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK DR",
            "address_2": "SUITE 550 CONCORD INTERNAL MEDICINE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280250926",
            "telephone_number": "704-403-1307",
            "fax_number": "704-403-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC-NORTHEAST, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CMC-NORTHEAST, INC.",
        "enumeration_date": "2006-06-05",
        "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": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI GROUP NUMBER",
            "identifier": "355573",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS EFF 7-1-07",
            "identifier": "019FP",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "CC2854",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE STANDARD, NON NWK",
            "identifier": "566000156022",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906973",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890279N",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS EFF PRIOR TO 7-1-07",
            "identifier": "0279N",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MEDICARE CHOICE",
            "identifier": "7232",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DF8926",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concord Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, NC

Sources for this page

  • 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.