CMC-NORTHEAST, INC. (NPI# 1013233527) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013233527 |
| Entity Type | Organization |
| Organization Name | CMC-NORTHEAST, INC. |
| Other Organization Name | NORTHEAST NEUROLOGY-COPPERFIELD |
| Practice Address |
270 Copperfield Blvd Ne Suite 201 Concord NC 28025-2441 |
| Practice Telephone | 7044031911 |
| Practice Fax Number | 7044031901 |
| Mailing Telephone | 7044031911 |
| Mailing Fax Number | 7044031901 |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2010-11-16 |
| Authorized Official Name | FRIEDA M LOWDER (SR VP) |
| Authorized Official Telephone | 7044034146 |
| Is Organization Subpart | Y |
| Parent Organization Name | CMC-NORTHEAST, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5915536 | 05 | |
| NC | RAILROAD MEDICARE PTAN | DF8926 | 01 |
| NC | MEDICARE PTAN, GROUP | 232009 | 01 |
| Other Name | Type Code |
|---|---|
| NorthEast Neurology-Copperfield | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043525280 | Cmc-northeast, Inc. | Psychiatry & Neurology | 6600 Wilkinson Blvd, Carolinas Pediatric Neurology Care - Holy Angels, Belmont, NC 28012-2796 | 2010-08-12 |
| 1184777617 | Cmc-northeast, Inc. | Counselor | 105 Yadkin Street, Suite 302, Albemarle, NC 28001-3454 | 2007-01-19 |
| 1497716989 | Cmc-northeast, Inc. | Internal Medicine | 219 Le Phillip Ct Ne, Northeast Lung Associates, Concord, NC 28025-2900 | 2006-04-01 |
| 1841595121 | Cmc-northeast, Inc. | Pediatrics | 129 Woodson St, Suite C, Salisbury, NC 28144-3255 | 2011-01-19 |
| 1669777942 | Cmc-northeast, Inc. | Psychiatry & Neurology | 129 Woodson St, Suite B, Salisbury, NC 28144-3255 | 2011-01-19 |
| 1093010407 | Cmc-northeast, Inc. | Pediatrics | 129 Woodson St, Suite A, Salisbury, NC 28144-3255 | 2011-01-14 |
| 1972806321 | Cmc-northeast, Inc. | Psychiatry & Neurology | 1001 Blythe Blvd, Suite 200 Cpnc - Charlotte Specialty Center, Charlotte, NC 28203-5866 | 2010-12-07 |
| 1174823900 | Cmc-northeast, Inc. | Psychiatry & Neurology | 2550 Court Dr, Suite 203, Gastonia, NC 28054-2152 | 2010-10-27 |
| 1831407295 | Cmc-northeast, Inc. | Internal Medicine | 920 Church St N, Northeast Transition of Care, Concord, NC 28025-2927 | 2010-09-20 |
| 1033424270 | Cmc-northeast, Inc. | Psychiatry & Neurology | 1781 Tate Blvd Se, Carolinas Pediatric Neurology Care - Hickory, Hickory, NC 28602-4251 | 2010-08-12 |
| Street Address |
270 COPPERFIELD BLVD NE SUITE 201 |
| City | CONCORD |
| State | NC |
| Zip Code | 28025-2441 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447248208 | Jerome Nymberg IIi | Family Medicine | 270 Copperfield Blvd Ne, Ste 102, Concord, NC 28025-2441 | 2005-10-06 |
| 1427500354 | Tara Bush | Physician Assistant | 270 Copperfield Blvd Ne, Ste 102, Concord, NC 28025-2441 | 2016-10-26 |
| 1013462894 | Shannon Elizabeth Rudolph | Pharmacist | 270 Copperfield Blvd Ne, Suite 101, Concord, NC 28025-2441 | 2016-08-22 |
| 1215481510 | Cody Clifton | Pharmacist | 270 Copperfield Blvd Ne, Suite 101, Concord, NC 28025-2441 | 2016-08-04 |
| 1588019798 | Megan Campbell | Family Medicine | 270 Copperfield Blvd Ne, Ste 102, Concord, NC 28025-2441 | 2016-04-26 |
| 1316322340 | Desiree Gaines | Pharmacist | 270 Copperfield Blvd Ne, Concord, NC 28025-2441 | 2015-07-20 |
| 1437536489 | May Royer | Family Medicine | 270 Copperfield Blvd Ne, Ste 102, Concord, NC 28025-2441 | 2015-04-29 |
| 1588051981 | Kristen Shaheen Williams | Physician Assistant | 270 Copperfield Blvd Ne, Suite 102, Concord, NC 28025-2441 | 2015-04-23 |
| 1558756155 | Rachel Koontz | Nurse Practitioner | 270 Copperfield Blvd Ne, Ste 102, Concord, NC 28025-2441 | 2015-03-31 |
| 1750799375 | Caroline Traylor | Pharmacist | 270 Copperfield Blvd Ne, Concord, NC 28025-2441 | 2014-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910729 | Renewed Mindset Therapeutic Services, Pllc | Social Worker | 349 Copperfield Blvd Suite L #334, Concord, NC 28025 | 2020-10-22 |
| 1194284380 | Carolinas Physicians Network Inc | Internal Medicine | 610 Alfred Brown Jr. Court, Concord, NC 28025 | 2019-03-18 |
| 1164913596 | Damarius Raymond Faggart | Counselor | 503 Amhurst Drive, Concord, NC 28025 | 2018-05-22 |
| 1437677085 | Kathryn Emily Kanauer | Counselor | 280 Executive Park Dr Ne, Concord, NC 28025 | 2017-09-05 |
| 1649794439 | Foster Health & Homecare, LLC | Home Health | 363 Church Street North, Suite 260-i, Concord, NC 28025 | 2017-08-02 |
| 1326569336 | Jessie Leigh Tilley-compton | Social Worker | 371 Amhurst St Sw, Concord, NC 28025 | 2017-06-29 |
| 1609305663 | Sarah Katherine Thompson | Licensed Practical Nurse | 248 Executive Park Dr, Concord, NC 28025 | 2017-06-05 |
| 1023463098 | Kiera Brown | Social Worker | 219 Lephillip Court, Concord, NC 28025 | 2016-04-27 |
| 1992169445 | Brittiny N. Ingram Vanterpool | Counselor | 250 Branchview Dr Sw, Concord, NC 28025 | 2016-04-11 |
| 1215399852 | The Charlotte-mecklenburg Hospital Authority | Clinic/Center | 840 Warren C. Coleman Blvd, Concord, NC 28025 | 2016-03-23 |
| Find all providers in zip 28025 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417044553 | Jeanine G Reczek | Psychiatry & Neurology | 300 Baker Ave, Concord, MA 01742-2131 | 2006-10-09 |
| 1841386968 | Eric K Larson | Psychiatry & Neurology | 280 Pleasant Street, Suite 12, Concord, NH 03301-2553 | 2006-10-05 |
| 1801997259 | Daniel Thomas Garber | Psychiatry & Neurology | 400 Penny Ln, Concord, NC 28025-1217 | 2006-09-26 |
| 1497773584 | Barry Lester Levin | Psychiatry & Neurology | Suite 760, 131 Ornac, Concord, MA 01743-4181 | 2006-07-17 |
| 1144207564 | Gary L. Stanton, Md PC | Psychiatry & Neurology | 131 Ornac John Cummings Bld., Concord, MA 01742 | 2005-12-28 |
| 1215914080 | Francois Picot | Psychiatry & Neurology | 315 Medical Park Dr, Ste 202, Concord, NC 28025-1902 | 2005-12-22 |
| 1598749939 | Gary Stanton | Psychiatry & Neurology | John Cummings Bldg, Emmerson Hospital, Ste 500, Concord, MA 01742 | 2005-11-30 |
| 1083026710 | Joshua Stone | Psychiatry & Neurology | 315 Medical Park Dr, Ste 202, Concord, NC 28025-1902 | 2014-05-29 |
| 1952711830 | Claire Emily Reynolds Carrazco | Psychiatry & Neurology | 133 Old Road To 9 Acre Cor, Concord, MA 01742 | 2014-05-01 |
| 1922428606 | Stephanie Mcneill | Psychiatry & Neurology | 315 Medical Park Dr, Ste 202, Concord, NC 28025-1902 | 2014-04-22 |
| Find all providers in CONCORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.