Active NPI
CMC-Northeast, Inc.
Doing business as NorthEast Psychiatric Services
- Psychiatry Physician
- Concord, NC
National Provider Identifier
1750343521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- CMC-NORTHEAST, INC.
- Doing business as
- NorthEast Psychiatric Services
- Practice address
- 380 Copperfield Blvd NE
Northeast Psychiatric Services
Concord, NC 28025-2402 - Phone
- (704) 403-1800
- Fax
- (704) 403-1836
- NPI assigned
- Apr 5, 2006
- Last updated
- Jun 1, 2012
- 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 11
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | ||
| Professional Counselor | 101YP2500X | NU | ||
| Psychologist | 103T00000X | NU | ||
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | NU | ||
| Clinical Psychologist | 103TC0700X | NU | ||
| Clinical Child & Adolescent Psychologist | 103TC2200X | NU | ||
| Family Psychologist | 103TF0000X | NU | ||
| Clinical Social Worker | 1041C0700X | NU | ||
| Marriage & Family Therapist | 106H00000X | NU | ||
| Psychiatry Physician | 2084P0800X | NU | Primary | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | NU |
Addresses
Primary practice location
380 Copperfield Blvd NE
Northeast Psychiatric Services
Concord, NC 28025-2402
Mailing address
380 Copperfield Blvd NE
Northeast Psychiatric Services
Concord, NC 28025-2402
Phone (704) 403-1800
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 355573 | Other | NC | MAMSI |
| 019G5 | Other | NC | BCBS EFF 7-1-07 |
| B948 | Other | NC | PARTNERS MEDICARE CHOICE |
| CC2854 | Other | NC | RAILROAD MEDICARE |
| 5907156 | Medicaid | NC | |
| 019G5 | Other | NC | BCBSNC |
| DF8926 | Other | NC | RAILROAD MEDICARE PTAN |
| 566000156021 | Other | NC | TRICARE STANDARD, NON NWK |
| 6005328 | Medicaid | NC | |
| 890240Y | Medicaid | NC |
Other names 1
- NorthEast Psychiatric Services
National Provider Directory
National Provider Directory- Part of
- CMC - Northeast Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1338508800000",
"number": "1750343521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "380 COPPERFIELD BLVD NE",
"address_2": "NORTHEAST PSYCHIATRIC SERVICES",
"city": "CONCORD",
"state": "NC",
"postal_code": "280252402",
"telephone_number": "704-403-1800",
"fax_number": "704-403-1836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 COPPERFIELD BLVD NE",
"address_2": "NORTHEAST PSYCHIATRIC SERVICES",
"city": "CONCORD",
"state": "NC",
"postal_code": "280252402",
"telephone_number": "704-403-1800",
"fax_number": "704-403-1836"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CMC-NORTHEAST, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CMC-NORTHEAST, INC.",
"enumeration_date": "2006-04-05",
"last_updated": "2012-06-01",
"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": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "355573",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS EFF 7-1-07",
"identifier": "019G5",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS MEDICARE CHOICE",
"identifier": "B948",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CC2854",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5907156",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSNC",
"identifier": "019G5",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PTAN",
"identifier": "DF8926",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE STANDARD, NON NWK",
"identifier": "566000156021",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6005328",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890240Y",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "NorthEast Psychiatric Services",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Concord, NC
- 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. (Concord Internal Medicine)
- 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
- CNC - Access Inc (All Ways Caring HomeCare)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.