NPIMap

Organization Active NPI

Cotswold Family Medicine

Doing business as Atrium Health Primary Care Cotswold Family Medicine

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1083642169
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COTSWOLD FAMILY MEDICINE
Doing business as
Atrium Health Primary Care Cotswold Family Medicine
Cotswold Family Medicine
Practice address
309 S Sharon Amity Rd
Ste 100
Charlotte, NC 28211-2978
Phone
(704) 446-2360
NPI assigned
Jun 29, 2006
Last updated
Mar 9, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
COTSWOLD FAMILY MEDICINEAs 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

309 S Sharon Amity Rd
Ste 100
Charlotte, NC 28211-2978

Mailing address

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

Other names 2

  • Atrium Health Primary Care Cotswold Family Medicine Doing business as
  • Cotswold Family Medicine 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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0244472CPN, Inc Dba Ah PC Cotswold Family Medicine309 S Sharon Amity Road, Suite 100, Charlotte, NC 28211Certificate of waiverDec 3, 2027

National Provider Directory

National Provider Directory
Part of
Cotswold Family Medicine

Member of 2

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

Locations

309 S Sharon Amity Rd
Ste 100
Charlotte, NC 28211
Phone (704) 366-7586

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

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": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1083642169",
    "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": "309 S SHARON AMITY RD",
            "address_2": "STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112978",
            "telephone_number": "704-446-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTSWOLD FAMILY MEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COTSWOLD FAMILY MEDICINE",
        "enumeration_date": "2006-06-29",
        "last_updated": "2023-03-09",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "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": "309 S Sharon Amity Rd",
            "address_2": "Ste 100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282112978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Atrium Health Primary Care Cotswold Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cotswold Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

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 Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.