CAROLINAS MEDICAL CENTER-NORTHEAST (NPI# 1881990687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881990687 |
| Entity Type | Organization |
| Organization Name | CAROLINAS MEDICAL CENTER-NORTHEAST |
| Other Organization Name | NORTHSIDE INTERNAL MEDICINE |
| Practice Address |
319 Penny Ln Suite A Concord NC 28025-1221 |
| Practice Telephone | 7044037575 |
| Practice Fax Number | 7044034326 |
| Mailing Telephone | 7044037575 |
| Mailing Fax Number | 7044034326 |
| Enumeration Date | 2011-01-27 |
| Last Update Date | 2013-07-31 |
| Authorized Official Name | FRIEDA M LOWDER (SR VP) |
| Authorized Official Telephone | 7044034146 |
| Is Organization Subpart | Y |
| Parent Organization Name | CAROLINAS MEDICAL CENTER-NORTHEAST |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | MEDICARE PTAN, GROUP | 232009 | 01 |
| NC | 5916552 | 05 |
| Other Name | Type Code |
|---|---|
| Northside Internal Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306181128 | Carolinas Medical Center-northeast | Obstetrics & Gynecology | 10030 Edison Square Dr, 100-a, Concord, NC 28027-8252 | 2012-12-05 |
| 1518237825 | Carolinas Medical Center-northeast | Dermatology | 200 Medical Park Drive, Suite 320, Concord, NC 28025-0936 | 2012-01-03 |
| 1912286410 | Carolinas Medical Center-northeast | Pediatrics | 101 East W T Harris Blvd, Bldg 3000, Suite 3301e, Charlotte, NC 28262-7000 | 2011-08-15 |
| 1386683472 | Carolinas Medical Center-northeast | Internal Medicine | 1085 Northeast Gateway Court, Ne, Suite 330, Concord, NC 28025-2406 | 2006-06-05 |
| 1487600813 | Carolinas Medical Center-northeast | Internal Medicine | 1085 Northeast Gateway Ct, Ne, Suite 200-a, Concord, NC 28025-2412 | 2006-05-26 |
| 1154769636 | Carolinas Medical Center-northeast | Psychiatry & Neurology | 600 Hospital Dr, Suite A, Monroe, NC 28112-6000 | 2013-06-06 |
| 1376989061 | Carolinas Medical Center-northeast | Pediatrics | 9625 Northcross Center Ct, Suite 102-g, Huntersville, NC 28078-7348 | 2013-05-21 |
| 1407299795 | Carolinas Medical Center-northeast | Internal Medicine | 101 E Wt Harris Blvd, Bldg 3000, Suite 3301-g, Charlotte, NC 28262-7000 | 2013-04-17 |
| 1053754341 | Carolinas Medical Center-northeast | Internal Medicine | 101 E Wt Harris Blvd, Bldg 3000, Suite 3301-f, Charlotte, NC 28262-7000 | 2013-04-17 |
| 1770821035 | Carolinas Medical Center-northeast | Psychiatry & Neurology | 101 E W T Harris Blvd, Ste 5202, Charlotte, NC 28262-3443 | 2013-01-22 |
| Street Address |
319 PENNY LN SUITE A |
| City | CONCORD |
| State | NC |
| Zip Code | 28025-1221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184611485 | David Christopherson | Family Medicine | 319 Penny Ln, Concord, NC 28025-1221 | 2005-10-02 |
| 1104384031 | Carolinas Physicians Network Inc | Family Medicine | 319 Penny Ln, Concord, NC 28025-1221 | 2019-03-11 |
| 1346603453 | The Charlotte-mecklenburg Hospital Authority | Family Medicine | 319 Penny Ln, Suite 107, Concord, NC 28025-1221 | 2016-04-05 |
| 1093142457 | The Charlotte-mecklenburg Hospital Authority | Internal Medicine | 319 Penny Ln, Suite A, Concord, NC 28025-1221 | 2013-10-01 |
| 1457788812 | The Charlotte-mecklenburg Hospital Authority | Internal Medicine | 319 Penny Ln, Suite B, Concord, NC 28025-1221 | 2013-10-01 |
| 1578709325 | Carolinas Medical Center-northeast | Internal Medicine | 319 Penny Ln, Suite B, Concord, NC 28025-1221 | 2008-12-29 |
| 1508918293 | Christopherson Family Medicine, LLC | Family Medicine | 319 Penny Ln, Concord, NC 28025-1221 | 2007-01-16 |
| 1699867218 | James Paul Rivell | Internal Medicine | 319 Penny Ln, Concord, NC 28025-1221 | 2006-09-29 |
| 1922100981 | Mahesh K Duggal | Internal Medicine | 319 Penny Ln, Suite B, Concord, NC 28025-1221 | 2006-09-01 |
| 1376514133 | Vincent L Keipper | Internal Medicine | 319 Penny Ln, Suite B, Concord, NC 28025-1221 | 2006-01-30 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821613480 | Carolinas Physicians Network Inc | Internal Medicine | 8815 Christenbury Pkwy Ste 30, Concord, NC 28027-0261 | 2020-06-10 |
| 1205395480 | Carolinas Physicians Network Inc | Internal Medicine | 845 Church St N Ste 101, Concord, NC 28025-4373 | 2019-03-18 |
| 1194284380 | Carolinas Physicians Network Inc | Internal Medicine | 610 Alfred Brown Jr. Court, Concord, NC 28025 | 2019-03-18 |
| 1063873842 | Beth Israel Lahey Health Primary Care, Inc. | Internal Medicine | 2284 Main Street, Lahey Health Primary Care, Concord, Concord, MA 01742 | 2016-03-08 |
| 1306259700 | Charis Gn Stone | Internal Medicine | 200 Medical Park Dr Ste 330, Concord, NC 28025-0937 | 2014-06-04 |
| 1255766267 | Pro Care Medical Group Inc | Internal Medicine | 1155 Rock Creek Way, Concord, CA 94521-5022 | 2013-09-10 |
| 1912339995 | Mehmet Sercan Marangoz | Internal Medicine | 18 Foundry St Ste 102, Concord, NH 03301 | 2013-08-01 |
| 1891032892 | Walter C Dueger | Internal Medicine | 215 Mountain Rd, Concord, NH 03301-6946 | 2013-01-10 |
| 1750680427 | Julian Lel | Internal Medicine | 131 Old Road To Nac Cor Bldg Suite660, Concord, MA 01742 | 2011-03-21 |
| 1164654885 | Patricia Ruze | Internal Medicine | 965 Elm St., Mci-concord, Concord, MA 01742-9106 | 2009-08-13 |
| 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.