Active NPI
CMC-Northeast, Inc.
Doing business as Concord Internal Medicine
- Internal Medicine Physician
- Concord, NC
National Provider Identifier
1730128810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- 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, 2010
- Organization subpart
- Yes
- Parent organization
- CMC-NORTHEAST, INC.
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
- VP Physician Services
- Phone
- (704) 403-4146
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 355573 | Other | NC | MAMSI GROUP NUMBER |
| 019FP | Other | NC | BCBS EFF 7-1-07 |
| CC2854 | Other | NC | RAILROAD MEDICARE GROUP |
| 566000156022 | Other | NC | TRICARE STANDARD, NON NWK |
| 5906973 | Medicaid | NC | |
| 890279N | Medicaid | NC | |
| 0279N | Other | NC | BCBS EFF PRIOR TO 7-1-07 |
| 7232 | Other | NC | PARTNERS MEDICARE CHOICE |
| DF8926 | Other | NC | RAILROAD MEDICARE PTAN |
Other names 1
- Concord Internal Medicine
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
- CMC-Northeast, Inc. (Northeast Critical Care Associates)
- CMC-Northeast, Inc. (NorthEast Plastic & Reconstructive Surgery)
- CMC-Northeast, Inc. (Northeast Inpatient Services)
- CMC-Northeast, Inc. (Carolina Pediatric Surgery)
- CMC-Northeast, Inc. (NorthEast Pediatric Pulmonology)
- CMC-Northeast, Inc. (NorthEast Psychiatric Services)
- CMC-Northeast, Inc. (NorthEast Transition of Care)
- CMC-Northeast, Inc. (Cabarrus County Employee Health Center)
- CMC-Northeast, Inc. (Northeast Pediatric Endocrinology)
- CMT Home Health Agency
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.