Organization Active NPI

Carolinas Medical Center-Northeast

Doing business as Northeast Internal and Integrative Medicine

  • Internal Medicine Physician
  • Concord, NC
National Provider Identifier
1942403787
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CAROLINAS MEDICAL CENTER-NORTHEAST
Doing business as
Northeast Internal and Integrative Medicine
Practice address
707 Memorial Blvd
Concord, NC 28025-2975
Phone
(704) 403-4050
Fax
(704) 403-7059
NPI assigned
Jun 8, 2007
Last updated
Mar 20, 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 Mar 20, 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
Phone
(704) 403-4146

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X NU
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

707 Memorial Blvd
Concord, NC 28025-2975

Mailing address

707 Memorial Blvd
Concord, NC 28025-2975
Phone (704) 403-4050

Other identifiers 3

IdentifierTypeStateIssuer
019FJOtherNCBCBS EFF 7/1/07
5906979MedicaidNC
DF8926OtherNCRAILROAD MEDICARE PTAN

Other names 1

  • NORTHEAST INTERNAL AND INTEGRATIVE MEDICINE Doing business as

National Provider Directory

National Provider Directory
Part of
CMC - Northeast Inc

Locations

707 Memorial Blvd
Concord, NC 28025
Phone (704) 403-7050

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": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363737600000",
    "number": "1942403787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 MEMORIAL BLVD",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252975",
            "telephone_number": "704-403-4050",
            "fax_number": "704-403-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 MEMORIAL BLVD",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252975",
            "telephone_number": "704-403-4050",
            "fax_number": "704-403-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS MEDICAL CENTER-NORTHEAST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS MEDICAL CENTER-NORTHEAST",
        "enumeration_date": "2007-06-08",
        "last_updated": "2013-03-20",
        "status": "A",
        "authorized_official_last_name": "LOWDER",
        "authorized_official_first_name": "FRIEDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "704-403-4146"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS EFF 7/1/07",
            "identifier": "019FJ",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906979",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DF8926",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHEAST INTERNAL AND INTEGRATIVE MEDICINE",
            "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 Mar 20, 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.