NPIMap

Organization Active NPI

CMC-Northeast, Inc.

Doing business as Northeast Pediatric Endocrinology

  • Pediatric Endocrinology Physician
  • Concord, NC
National Provider Identifier
1912946922
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
Legal business name
CMC-NORTHEAST, INC.
Doing business as
Northeast Pediatric Endocrinology
Practice address
100 Medical Park Dr
Suite 310 - Northeast Pediatric Endocrinology
Concord, NC 28025-2966
Phone
(704) 403-2660
Fax
(704) 403-2670
NPI assigned
Jun 5, 2006
Last updated
Nov 18, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
CMC-NORTHEAST, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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
Pediatric Endocrinology Physician 2080P0205X NU Primary

Addresses

Primary practice location

100 Medical Park Dr
Suite 310 - Northeast Pediatric Endocrinology
Concord, NC 28025-2966

Mailing address

100 Medical Park Dr
Suite 310 - Northeast Pediatric Endocrinology
Concord, NC 28025-2966
Phone (704) 403-2660

Other identifiers 10

IdentifierTypeStateIssuer
015Y2OtherNCBCBS EFF PRIOR TO 7-1-07
QPB690MedicaidSC
355573OtherNCMAMSI
89015Y2MedicaidNC
566000156020OtherNCTRICARE STANDARD, NON NWK
I092OtherNCPARTNERS MEDICARE CHOICE
4462028OtherNCAETNA
5906953MedicaidNC
019FTOtherNCBCBS EFF 7-1-07
DF8926OtherNCRAILROAD MEDICARE PTAN

Other names 1

  • NORTHEAST PEDIATRIC ENDOCRINOLOGY 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

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": "1321574400000",
    "number": "1912946922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PARK DR",
            "address_2": "SUITE 310 - NORTHEAST PEDIATRIC ENDOCRINOLOGY",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252966",
            "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 - NORTHEAST PEDIATRIC ENDOCRINOLOGY",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252966",
            "telephone_number": "704-403-2660",
            "fax_number": "704-403-2670"
        }
    ],
    "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": "2011-11-18",
        "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": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS EFF PRIOR TO 7-1-07",
            "identifier": "015Y2",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "QPB690",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "355573",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015Y2",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE STANDARD, NON NWK",
            "identifier": "566000156020",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MEDICARE CHOICE",
            "identifier": "I092",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4462028",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906953",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS EFF 7-1-07",
            "identifier": "019FT",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DF8926",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHEAST PEDIATRIC ENDOCRINOLOGY",
            "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 Nov 18, 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.