NPIMap

Organization Active NPI

CMC Northeast

  • Public Health or Welfare Agency
  • Concord, NC
National Provider Identifier
1821203068
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
CMC NORTHEAST
Practice address
920 Church St N
Concord, NC 28025-2927
Phone
(704) 783-3000
NPI assigned
May 11, 2007
Last updated
Apr 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Greg Gombar
Title
Administrator
Phone
(704) 355-2154

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

920 Church St N
Concord, NC 28025-2927

Mailing address

PO Box 669347
Charlotte, NC 28266-9347
Phone (704) 512-6438

Other identifiers 1

IdentifierTypeStateIssuer
3408554MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
CMC RX Pavilion44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303257600000",
    "number": "1821203068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 669347",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282669347",
            "telephone_number": "704-512-6438",
            "fax_number": "704-512-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252927",
            "telephone_number": "704-783-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC NORTHEAST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "GOMBAR",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-355-2154",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408554",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 20, 2011; 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.