NPIMap

Organization Active NPI

Carolinas Medical Center-Northeast

Doing business as Carolinas Pediatric Neurology Care - Concord

  • Neurology with Special Qualifications in Child Neurology Physician
  • Concord, NC
National Provider Identifier
1730135047
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
Legal business name
CAROLINAS MEDICAL CENTER-NORTHEAST
Doing business as
Carolinas Pediatric Neurology Care - Concord
Practice address
100 Medical Park Dr
Suite 310
Concord, NC 28025-2948
Phone
(704) 403-2660
Fax
(704) 403-2670
NPI assigned
May 26, 2006
Last updated
Jul 31, 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 Jul 31, 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
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X NU Primary

Addresses

Primary practice location

100 Medical Park Dr
Suite 310
Concord, NC 28025-2948

Mailing address

100 Medical Park Dr
Suite 310
Concord, NC 28025-2948
Phone (704) 403-2660

Other identifiers 10

IdentifierTypeStateIssuer
355573OtherNCMAMSI
DF8926OtherNCRAILROAD MEDICARE PTAN
5906952MedicaidNC
89015Y1MedicaidNC
015Y1OtherNCBCBS GROUP ID
7837542OtherNCAETNA
I912OtherNCPARTNERS MEDICARE CHOICE
566000156020OtherNCTRICARE STANDARD, NON NWK
NPB455MedicaidSC
019FGOtherNCBCBS EFF 7-1-07

Other names 1

  • CAROLINAS PEDIATRIC NEUROLOGY CARE - CONCORD Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CMC - Northeast Inc44 organizations share this tax ID, including this one
Part of
CMC - Northeast Inc

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

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": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1730135047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PARK DR",
            "address_2": "SUITE 310",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252948",
            "telephone_number": "704-403-2660",
            "fax_number": "704-403-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PARK DR",
            "address_2": "SUITE 310",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252948",
            "telephone_number": "704-403-2660",
            "fax_number": "704-403-2670"
        }
    ],
    "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": "2013-07-31",
        "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": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "355573",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DF8926",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906952",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015Y1",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP ID",
            "identifier": "015Y1",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7837542",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MEDICARE CHOICE",
            "identifier": "I912",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE STANDARD, NON NWK",
            "identifier": "566000156020",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPB455",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS EFF 7-1-07",
            "identifier": "019FG",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAROLINAS PEDIATRIC NEUROLOGY CARE - CONCORD",
            "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 Jul 31, 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.