NPIMap

Organization Active NPI

Medical Practice of Concord, PC

  • Internal Medicine Physician
  • Concord, NC
National Provider Identifier
1942472667
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9501609 Issued in NC
Legal business name
MEDICAL PRACTICE OF CONCORD, PC
Practice address
940 Lee Ann Dr NE
Concord, NC 28025-2957
Phone
(704) 262-7240
Fax
(704) 262-7249
NPI assigned
Apr 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Authorized official

Name
Dr. Edward R Mogabgab, MD
Title
Business Owner
Phone
(704) 262-7240

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 9501609 NC Primary

Addresses

Primary practice location

940 Lee Ann Dr NE
Concord, NC 28025-2957

Mailing address

940 Lee Ann Dr NE
Concord, NC 28025-2957
Phone (704) 262-7240

National Provider Directory

National Provider Directory

Locations

940 Lee Ann Dr NE
Concord, NC 28025
Phone (704) 262-7240

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1942472667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 LEE ANN DR NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252957",
            "telephone_number": "704-262-7240",
            "fax_number": "704-262-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 LEE ANN DR NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252957",
            "telephone_number": "704-262-7240",
            "fax_number": "704-262-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PRACTICE OF CONCORD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "MOGABGAB",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "704-262-7240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9501609",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 2, 2008; 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.