NPIMap

Carolinas Physicians Network Inc

Organization Active NPI Hospitalist Physician · Kings Mountain, NC

NPI 1114348802 · NPPES record last updated Mar 9, 2023

Key facts

NPI
1114348802
Entity type
Organization (NPI type 2)
Primary specialty
Hospitalist Physician 208M00000X
Legal business name
CAROLINAS PHYSICIANS NETWORK INC
Practice address
706 W King St
Kings Mountain, NC 28086-2708
Phone
(980) 487-3751
NPI assigned
Dec 23, 2013
Organization subpart
Yes
Parent organization (as reported)
CAROLINAS PHYSICIANS NETWORK INC

Authorized official

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

Practitioners 21

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031219000455 NC Part B Supplier - Clinic/Group Practice 3375449655 Receives reassigned benefits from 1,949 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Part of
Cotswold Urgent Care

Locations

920 Church St N
Ste 255B
Concord, NC 28025
Phone (704) 403-1331

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X
Hospitalist Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208M00000X Yes

Addresses

Primary practice location

706 W King St
Kings Mountain, NC 28086-2708

Mailing address

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

Other names

  • Carolinas Hospitalist Group - Kings Mountain Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
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

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": "1387756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1114348802",
    "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": "706 W KING ST",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280862708",
            "telephone_number": "980-487-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "enumeration_date": "2013-12-23",
        "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": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "706 W King St",
            "city": "Kings Mountain",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280862708",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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"
        }
    ],
    "other_names": [
        {
            "organization_name": "Carolinas Hospitalist Group - Kings Mountain",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carolinas Hospitalist Group - Kings Mountain",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kings Mountain, NC

All providers in Kings Mountain, NC · Hospitalist Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.