NPIMap

Organization Active NPI

CMC-Northeast, Inc.

Doing business as Carolinas Pediatric Neurology Care - Charlotte Specialty Center

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
National Provider Identifier
1972806321
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
Legal business name
CMC-NORTHEAST, INC.
Doing business as
Carolinas Pediatric Neurology Care - Charlotte Specialty Center
Practice address
1001 Blythe Blvd
Suite 200 CPNC - Charlotte Specialty Center
Charlotte, NC 28203-5866
Phone
(704) 381-8840
Fax
(704) 381-8848
NPI assigned
Dec 7, 2010
Last updated
Nov 15, 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 15, 2011

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
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X NU Primary

Addresses

Primary practice location

1001 Blythe Blvd
Suite 200 CPNC - Charlotte Specialty Center
Charlotte, NC 28203-5866

Mailing address

1001 Blythe Blvd
Suite 200 CPNC - Charlotte Specialty Center
Charlotte, NC 28203-5866
Phone (704) 381-8840

Other identifiers 2

IdentifierTypeStateIssuer
NPB455MedicaidSC
5916349MedicaidNC

Other names 1

  • Carolinas Pediatric Neurology Care - Charlotte Specialty Center 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": "1291680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1972806321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD",
            "address_2": "SUITE 200 CPNC - CHARLOTTE SPECIALTY CENTER",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035866",
            "telephone_number": "704-381-8840",
            "fax_number": "704-381-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD",
            "address_2": "SUITE 200 CPNC - CHARLOTTE SPECIALTY CENTER",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035866",
            "telephone_number": "704-381-8840",
            "fax_number": "704-381-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC-NORTHEAST, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CMC-NORTHEAST, INC.",
        "enumeration_date": "2010-12-07",
        "last_updated": "2011-11-15",
        "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": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPB455",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5916349",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolinas Pediatric Neurology Care - Charlotte Specialty Center",
            "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 Nov 15, 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.