NPIMap

The Charlotte-Mecklenburg Hospital Authority

Organization Active NPI Dentist · Charlotte, NC

NPI 1104289685 · NPPES record last updated Mar 9, 2023

Key facts

NPI
1104289685
Entity type
Organization (NPI type 2)
Primary specialty
Dentist 122300000X
Legal business name
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
Practice address
1601 Abbey PL
Ste 220
Charlotte, NC 28209-3835
Phone
(704) 512-2110
NPI assigned
Apr 1, 2016
Organization subpart
Yes
Parent organization (as reported)
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY

Authorized official

Name
Scott Rissmiller NPI 1851316558
Title
Enterprise Evp
Phone
(704) 355-8675

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Owned or controlled facilities with NPI records 41

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 41

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2146864Atrium Health Oral Medicine & Maxillofacial
1601 Abbey Place, Suite 220, Charlotte, NC 28209		Certificate of waiverApr 8, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NC

All facility ownership & control disclosures 35

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Carolinas Medical Center
Charlotte, NC · CCN 340113		 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Nov 7, 2007
Nov 7, 2007
Atrium Health Navicent Rehabilitation Hopsital
Macon, GA · CCN 113029		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2019
Atrium Health Floyd Medical Center
Rome, GA · CCN 110054		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jul 14, 2021
Atrium Health Floyd Medical Center Behavioral Health
Rome, GA · CCN 11S054		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jul 14, 2021
Atrium Health Floyd Medical Center
Rome, GA · CCN 11T054		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jul 14, 2021
Atrium Health Navicent the Medical Center
Macon, GA · CCN 110107		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2019
Atrium Health Navicent Behavioral Health
Macon, GA · CCN 11S107		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2019
Atrium Health Navicent Peach
Byron, GA · CCN 111310		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2019
Atrium Health Navicent Peach
Byron, GA · CCN 11Z310		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2019
Atrium Health Floyd Polk Medical Center
Cedartown, GA · CCN 111330		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jul 14, 2021
Atrium Health Floyd Polk Medical Center
Cedartown, GA · CCN 11Z330		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jul 14, 2021
Atrium Health Floyd Cherokee Medical Center
Centre, AL · CCN 010022		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jul 14, 2021
Atrium Health Navicent Baldwin
Milledgeville, GA · CCN 110150		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2019
Atrium Health Stanly
Albemarle, NC · CCN 340119		 Hospital 5% Or Greater Direct Ownership Interest (100%) Mar 14, 2025
Atrium Health Anson
Wadesboro, NC · CCN 340084		 Hospital 5% Or Greater Direct Ownership Interest (100%) Mar 14, 2025
Atrium Health Lincoln
Lincolnton, NC · CCN 340145		 Hospital 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2026
Atrium Health Cleveland
Shelby, NC · CCN 340021		 Hospital 5% Or Greater Indirect Ownership Interest (100%) Feb 1, 2026
Carlyle Place
Macon, GA · CCN 115680		 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2019
Sardis Oaks
Charlotte, NC · CCN 345331		 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 1, 2020
Apr 14, 2025
Jesse Helms Nursing Center
Monroe, NC · CCN 345097		 Skilled nursing facility Operational/Managerial Control Feb 1, 2020
Huntersville Oaks
Huntersville, NC · CCN 345096		 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 1, 2020
Apr 24, 2025
Cleveland Pines
Shelby, NC · CCN 345282		 Skilled nursing facility Operational/Managerial Control Feb 1, 2020
Stanly Manor
Albemarle, NC · CCN 345281		 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 1, 2020
Mar 26, 2026
Atrium Health Navicent Baldwin Skilled Nursing Unit
Milledgeville, GA · CCN 115649		 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2019
Atrium Health Navicent at Home
Macon, GA · CCN 117023		 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2019
Atrium Health at Home Cleveland
Shelby, NC · CCN 347013		 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Nov 16, 2007
Jul 1, 2009
Atrium Health at Home Blue Ridge
Morganton, NC · CCN 347181		 Home health agency 5% Or Greater Direct Ownership Interest (100%) Nov 16, 2007
Atrium Health at Home University City
Charlotte, NC · CCN 347254		 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jul 1, 2009
Jul 1, 2009
Atrium Health at Home York
Rock Hill, SC · CCN 427131		 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Nov 15, 2007
Jul 1, 2009
Atrium Health Hospice & Palliative Care Cabarrus
Kannapolis, NC · CCN 341508		 Hospice 5% Or Greater Indirect Ownership Interest (100%) Jul 1, 2007
Atrium Health Navicent Hospice Pine Pointe
Macon, GA · CCN 111519		 Hospice 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2019
Atrium Health Navicent Primary Care Fort Valley
Fort Valley, GA · CCN 118539		 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2019
Atrium Health Floyd Cherokee Medical Center Rural Health Clinic Piedmo
Piedmont, AL · CCN 013495		 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Jul 14, 2021
Atrium Health Floyd Cherokee Medical Center Rural Health Clinic Centre
Centre, AL · CCN 013494		 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Jul 14, 2021
Atrium Health Floyd Cherokee Medical Center Rural Health Clinic Cherok
Centre, AL · CCN 013485		 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Jul 14, 2021

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040421001689 NC Part B Supplier - Clinic/Group Practice 2365353885 Receives reassigned benefits from 17 practitioners
1 other NPI on this enrollment
Practice locations: Charlotte, NC
O20240617001402 NC DME Supplier - Physician - General Practice 5294832598 Practice locations: Charlotte, NC

National Provider Directory

Part of
Charlotte Mecklenburg Hospital Authority

Locations

625 Bethany Rd
Albemarle, NC 28001
Phone (704) 982-0770

10660 Park Rd
Ste 2100
Charlotte, NC 28210
Phone (980) 442-0410

130 Lake Concord Rd NE
Concord, NC 28025
Phone (704) 788-1192

1085 NE Gateway Ct NE
Ste 300
Concord, NC 28025
Phone (704) 403-1430

1065 NE Gateway Ct NE
Concord, NC 28025
Phone (704) 403-7500

16455 Statesville Rd
Ste 310
Huntersville, NC 28078
Phone (704) 801-2501

201 Dale Earnhardt Blvd
Ste 200
Kannapolis, NC 28081
Phone (704) 403-7300

411 Cherryville Rd
Shelby, NC 28150
Phone (704) 482-1191

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist
Group: 193400000X SINGLE SPECIALTY GROUP		 122300000X Yes

Addresses

Primary practice location

1601 Abbey PL
Ste 220
Charlotte, NC 28209-3835

Mailing address

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

Other names

  • Atrium Health Oral Medicine & Maxillofacial Surgery Doing business as
  • Carolinas Center for Oral Health Doing business as

Electronic endpoints

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 9, 2023.

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1104289685",
    "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": "1601 ABBEY PL",
            "address_2": "STE 220",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093835",
            "telephone_number": "704-512-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
        "enumeration_date": "2016-04-01",
        "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": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "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": "1601 Abbey Pl",
            "address_2": "Ste 220",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282093835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Atrium Health Oral Medicine & Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carolinas Center for Oral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

All providers in Charlotte, NC · Dentist in North Carolina

Sources for this page

Verify at the official NPI Registry.