Active NPI
The Charlotte-Mecklenburg Hospital Authority
- Surgery Physician
- Denver, NC
National Provider Identifier
1124359112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
- Practice address
- 1585 Forney Creek Pkwy
Suite 2350
Denver, NC 28037-9514 - Phone
- (704) 735-7069
- NPI assigned
- Jan 15, 2010
- Organization subpart
- Yes
- Parent organization
- THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | Primary |
Addresses
Primary practice location
1585 Forney Creek Pkwy
Suite 2350
Denver, NC 28037-9514
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Phone (704) 631-0002
Other names 2
- Atrium Health General Surgery Denver
- CMC Surgery - Denver
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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 NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100309000605 | NC | Part B Supplier - Clinic/Group Practice | 2961310685 |
Receives reassigned benefits from 1,831 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Part of
- Charlotte Mecklenburg Hospital Authority
Locations
1585 Forney Creek Pkwy
Ste 2350
Denver, NC 28037
Phone (980) 212-4000
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nurse Practitioner
- Charlotte, NC
- NPI 1376313718
-
- Nurse Practitioner
- Shelby, NC
- NPI 1255683405
-
- Gastroenterology Physician
- Lincolnton, NC
- NPI 1780656439
-
- Physician Assistant
- Lincolnton, NC
- NPI 1831889856
-
- Physician Assistant
- Gastonia, NC
- NPI 1588219182
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263513600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678320000000",
"number": "1124359112",
"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": "1585 FORNEY CREEK PKWY",
"address_2": "SUITE 2350",
"city": "DENVER",
"state": "NC",
"postal_code": "280379514",
"telephone_number": "704-735-7069"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
"enumeration_date": "2010-01-15",
"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": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"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": "1585 Forney Creek Pkwy",
"address_2": "Suite 2350",
"city": "Denver",
"state": "NC",
"country_code": "US",
"postal_code": "280379514",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Atrium Health General Surgery Denver",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "CMC Surgery - Denver",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Denver, 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 enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.