Carolinas Physicians Network Inc
Organization Active NPI Internal Medicine Physician · Kings Mountain, NC
NPI 1063854057 · NPPES record last updated Mar 9, 2023
Key facts
- NPI
- 1063854057
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- CAROLINAS PHYSICIANS NETWORK INC
- Practice address
- 2202 Carolina PL
Ste 100
Kings Mountain, NC 28086-8807 - Phone
- (980) 487-2290
- NPI assigned
- Jul 19, 2013
- Organization subpart
- Yes
- Parent organization (as reported)
- CAROLINAS PHYSICIANS NETWORK INC
Authorized official
- Name
- Scott Rissmiller
- Title
- Enterprise Evp
- Phone
- (704) 355-8675
Corporate family (same tax ID) 17
Practitioners 17
-
Janieta Roel Brown, FNP
-
Aleshia Jo Gaddy, PA
-
Jitendra Patel, MD
-
Allen Shepard, D.O.
-
Sowmya K Suryanarayanan, M. D.
-
Amy Cabaniss Clinton, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040115000819 | NC | Part B Supplier - Clinic/Group Practice | 3375449655 |
Receives reassigned benefits from 2,518 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Cotswold Urgent Care
- Part of
- Cotswold Urgent Care
Locations
2202 Carolina Pl
#100
Kings Mountain, NC 28086
Phone (980) 487-2270
502 W King St
Ste A
Kings Mtn, NC 28086
Phone (980) 487-2240
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
2202 Carolina PL
Ste 100
Kings Mountain, NC 28086-8807
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Phone (704) 631-0002
Other names
- Atrium Health Primary Care Kings Mountain Internal Medicine
- Kings Mountain Internal Medicine
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Ambulatory@direct.carolinashealthcare.org | Atrium Health | |
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
Other providers in Kings Mountain, NC
- Jeffrey P Carley
- Carolina Family Care, P.a.
- Carolina Speech Therapy Services, PLLC
- Carolina Therapeutic Solutions
- Carolinas Emergency Physicians, P.a.
- Carolinas Physicians Network Inc
- Carolinas Physicians Network Inc
- Carolinas Physicians Network Inc
- Carolinas Physicians Network Inc
- Carolinas Physicians Network Inc
All providers in Kings Mountain, NC · Internal Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.