CMC-NORTHEAST, INC. (NPI# 1912946922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912946922 |
| Entity Type | Organization |
| Organization Name | CMC-NORTHEAST, INC. |
| Other Organization Name | NORTHEAST PEDIATRIC ENDOCRINOLOGY |
| Practice Address |
100 Medical Park Dr Suite 310 - Northeast Pediatric Endocrinology Concord NC 28025-2966 |
| Practice Telephone | 7044032660 |
| Practice Fax Number | 7044032670 |
| Mailing Telephone | 7044032660 |
| Mailing Fax Number | 7044032670 |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2011-11-18 |
| Authorized Official Name | FRIEDA M LOWDER (VP PHYSICIAN SERVICES) |
| 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 | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | MAMSI | 355573 | 01 |
| SC | QPB690 | 05 | |
| NC | BCBS EFF 7-1-07 | 019FT | 01 |
| NC | RAILROAD MEDICARE PTAN | DF8926 | 01 |
| NC | TRICARE STANDARD, NON NWK | 566000156020 | 01 |
| NC | BCBS EFF PRIOR TO 7-1-07 | 015Y2 | 01 |
| NC | 5906953 | 05 | |
| NC | 89015Y2 | 05 | |
| NC | PARTNERS MEDICARE CHOICE | I092 | 01 |
| NC | AETNA | 4462028 | 01 |
| Other Name | Type Code |
|---|---|
| NORTHEAST PEDIATRIC ENDOCRINOLOGY | 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 |
100 MEDICAL PARK DR SUITE 310 - NORTHEAST PEDIATRIC ENDOCRINOLOGY |
| City | CONCORD |
| State | NC |
| Zip Code | 28025-2966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700882958 | Patrick Anonick | Internal Medicine | 100 Medical Park Dr, Ste 210, Concord, NC 28025-2948 | 2005-06-22 |
| 1538700620 | Ashley Stewart | Nurse Practitioner | 100 Medical Park Dr, Ste 210, Concord, NC 28025-2948 | 2019-10-01 |
| 1659858330 | Krista Diiorio | Nurse Practitioner | 100 Medical Park Dr, Suite 310, Concord, NC 28025-2948 | 2018-07-25 |
| 1255829768 | Jessica Beal | Physician Assistant | 100 Medical Park Dr, Ste 110, Concord, NC 28025-2948 | 2018-04-30 |
| 1093216244 | Chris Larck | Pharmacist | 100 Medical Park Dr, Concord, NC 28025-2948 | 2018-02-23 |
| 1164948022 | Kathleen Bloom | Nurse Practitioner | 100 Medical Park Dr, Ste 210, Concord, NC 28025-2948 | 2017-08-22 |
| 1043736713 | Lauren Cartwright | Physician Assistant | 100 Medical Park Dr, Ste 210, Concord, NC 28025-2948 | 2017-08-15 |
| 1013439892 | Brittany Dillon | Nurse Practitioner | 100 Medical Park Dr, Suite 310, Concord, NC 28025-2948 | 2017-07-12 |
| 1932650892 | Kevin Hixson | Physician Assistant | 100 Medical Park Dr, Ste 210, Concord, NC 28025-2948 | 2016-10-17 |
| 1891243929 | Scott Palmer | Nurse Practitioner | 100 Medical Park Dr, Ste 110, Concord, NC 28025-2948 | 2016-09-19 |
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| 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 | 2080P0205X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Endocrinology |
| A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073179867 | Novant Medical Group, Inc. | Pediatrics | 311 Coddle Market Dr Nw Ste 200, Concord, NC 28027-2432 | 2019-05-16 |
| 1912334335 | The Charlotte-mecklenburg Hospital Authority | Pediatrics | 100 Medical Park Dr, Suite 310b, Concord, NC 28025-2948 | 2013-09-30 |
| 1467558924 | Kecha Lynshue | Pediatrics | 100 Medical Park Dr, Suite 310b, Concord, NC 28025-2948 | 2006-09-15 |
| 1538131776 | Thea Pfeifer | Pediatrics | 100 Medical Park Dr, Suite 310b, Concord, NC 28025-2948 | 2006-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124202114 | Jennifer Rachel Law | Pediatrics | 3341 Mbrb Cb 7039, University of North Carolina, Chapel Hill, NC 27599-0001 | 2007-12-26 |
| 1245443126 | Nina Jain | Pediatrics | Unc, Cb # 7039, 3341 Biomolecular (mbrb), Chapel Hill, NC 27599-0001 | 2007-05-08 |
| 1376696062 | Cmc-northeast, Inc | Pediatrics | 16623 Birkdale Cmns Pkwy, Suite 110, Ne Pediatric Endo, Huntersville, NC 28078-5621 | 2007-01-18 |
| 1801825914 | Lisa Houchin | Pediatrics | 4501 Cameron Valley Pkwy, Ste 200, Charlotte, NC 28211-4297 | 2006-07-01 |
| 1437141611 | Maria Janae Henwood-finley | Pediatrics | 2150 Herbert Ct, Ecu Pediatric Specialty Clinic, Greenville, NC 27834-3736 | 2005-08-16 |
| 1265097695 | Wakemed Specialists Group, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-05-01 |
| 1386164051 | Novant Medical Group, Inc | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2017-06-23 |
| 1518378553 | Wake Specialty Physicians, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2014-05-13 |
| 1902233380 | The Charlotte-mecklenburg Hospital Authority | Pediatrics | 9625 Northcross Center Ct, Ste 102c, Huntersville, NC 28078-7348 | 2013-10-01 |
| 1700213113 | The Charlotte-mecklenburg Hospital Authority | Pediatrics | 101 E Wt Harris Blvd, Bldg 3000 Ste 3301c, Charlotte, NC 28262-3485 | 2013-09-30 |
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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.