NPIMap

Organization Active NPI

Carolinas Medical Center-Northeast

Doing business as Carolina Pediatric Gastroenterology-University

  • Pediatric Gastroenterology Physician
  • Charlotte, NC
National Provider Identifier
1912286410
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
Legal business name
CAROLINAS MEDICAL CENTER-NORTHEAST
Doing business as
Carolina Pediatric Gastroenterology-University
Practice address
101 East W T Harris Blvd
BLDG 3000, Suite 3301E
Charlotte, NC 28262-7000
Phone
(704) 403-2660
Fax
(704) 403-2670
NPI assigned
Aug 15, 2011
Last updated
Mar 6, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROLINAS MEDICAL CENTER-NORTHEASTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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

Authorized official

Name
Frieda M Lowder
Title
Sr VP
Phone
(704) 403-4146

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X Primary

Addresses

Primary practice location

101 East W T Harris Blvd
BLDG 3000, Suite 3301E
Charlotte, NC 28262-7000

Mailing address

101 East W T Harris Blvd
BLDG 3000, Suite 3301E
Charlotte, NC 28262-7000
Phone (704) 403-2660

Other identifiers 1

IdentifierTypeStateIssuer
5919138MedicaidNC

Other names 1

  • Carolina Pediatric Gastroenterology-University 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": "1313366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330992000000",
    "number": "1912286410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 EAST W T HARRIS BLVD",
            "address_2": "BLDG 3000, SUITE 3301E",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282627000",
            "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": "101 EAST W T HARRIS BLVD",
            "address_2": "BLDG 3000, SUITE 3301E",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282627000",
            "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": "2011-08-15",
        "last_updated": "2012-03-06",
        "status": "A",
        "authorized_official_last_name": "LOWDER",
        "authorized_official_first_name": "FRIEDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR VP",
        "authorized_official_telephone_number": "704-403-4146"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5919138",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Pediatric Gastroenterology-University",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.

Verify at the official NPI Registry.