Organization Active NPI

Carolinas Physicians Network Inc

Doing business as Atrium Health Urgent Care

  • Emergency Medicine Physician
  • Indian Land, SC
National Provider Identifier
1043819535
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CAROLINAS PHYSICIANS NETWORK INC
Doing business as
Atrium Health Urgent Care
Practice address
9623 Redstone Dr
Ste 300
Indian Land, SC 29707-5403
Phone
(704) 667-4840
NPI assigned
Oct 26, 2020
Last updated
Mar 9, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROLINAS PHYSICIANS NETWORK INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Authorized official

Name
Scott Rissmiller
Title
Enterprise Evp
Phone
(704) 355-8675

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Pediatrics Physician 208000000X

Addresses

Primary practice location

9623 Redstone Dr
Ste 300
Indian Land, SC 29707-5403

Mailing address

PO Box 19305
Charlotte, NC 28219-9305
Phone (704) 631-0002

Other names 1

  • Atrium Health Urgent Care Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address Ambulatory@direct.carolinashealthcare.org Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031209000106 SC Part B Supplier - Clinic/Group Practice 3375449655 Receives reassigned benefits from 359 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rock Hill, SC; Fort Mill, SC; Lancaster, SC; Indian Land, SC; Greenville, SC
O20210723001217 SC DME Supplier - Physician - General Practice 3375449655 Practice locations: Indian Land, SC

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Part of
Carolinas Physicians Network Inc

Member of 19

Organizations this organization is a member of, according to the National Provider Directory.

View all 19

Locations

704 Gold Hill Rd
Ste 1200
Fort Mill, SC 29715
Phone (704) 667-3380

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1043819535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305",
            "telephone_number": "704-631-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9623 REDSTONE DR",
            "address_2": "STE 300",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297075403",
            "telephone_number": "704-667-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "enumeration_date": "2020-10-26",
        "last_updated": "2023-03-09",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "RISSMILLER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "ENTERPRISE EVP",
        "authorized_official_telephone_number": "704-355-8675"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "9623 Redstone Dr",
            "address_2": "Ste 300",
            "city": "Indian Land",
            "state": "SC",
            "country_code": "US",
            "postal_code": "297075403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Atrium Health Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indian Land, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.