Active NPI
The Charlotte-Mecklenburg Hospital Authority
Doing business as Atrium Health Levine Children's Neonatal Follow-up
- Pediatrics Physician
- Charlotte, NC
National Provider Identifier
1154820934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
- Doing business as
- Atrium Health Levine Children's Neonatal Follow-up
CHS Neonatal Follow-up Clinic - Practice address
- 2608 E 7TH St
Ste 100D
Charlotte, NC 28204-4375 - Phone
- (704) 403-2626
- NPI assigned
- Feb 7, 2018
- Last updated
- May 8, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | Primary | ||
| Neonatal-Perinatal Medicine Physician | 2080N0001X |
Addresses
Primary practice location
2608 E 7TH St
Ste 100D
Charlotte, NC 28204-4375
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Phone (704) 631-0002
Other practice location 1
1001 Blythe Blvd
Charlotte, NC 28203-5866
Phone (704) 381-1450
Other names 2
- Atrium Health Levine Children's Neonatal Follow-up
- CHS Neonatal Follow-up Clinic
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
- The Charlotte Mecklenburg
Locations
2608 E 7th St
Ste 100
Charlotte, NC 28204
Phone (704) 403-2626
Practitioners & affiliated clinicians
Practitioners 12
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.
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Charlotte, NC
- NPI 1639660210
-
- Pediatrics Physician
- Charlotte, NC
- NPI 1639435282
-
- Medical Oncology Physician
- Charlotte, NC
- NPI 1093702201
-
- Pediatrics Physician
- Charlotte, NC
- NPI 1326228214
-
- Nurse Practitioner
- Charlotte, NC
- NPI 1013157254
-
- Neonatal-Perinatal Medicine Physician
- Charlotte, NC
- NPI 1417085325
Pediatrics
-
- Pediatrics Physician
- Charlotte, NC
- NPI 1053573857
-
- Nurse Practitioner
- Charlotte, NC
- NPI 1164499059
-
- Registered Dietitian
- Charlotte, NC
- NPI 1699561894
-
- Psychologist
- Charlotte, NC
- NPI 1487674347
-
- Pediatrics Physician
- Charlotte, NC
- NPI 1679136063
-
- Neonatal-Perinatal Medicine Physician
- Charlotte, NC
- NPI 1245736065
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517961600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1683504000000",
"number": "1154820934",
"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": "2608 E 7TH ST",
"address_2": "STE 100D",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282044375",
"telephone_number": "704-403-2626"
}
],
"practiceLocations": [
{
"address_1": "1001 Blythe Blvd",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282035866",
"country_code": "US",
"telephone_number": "704-381-1450",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
"enumeration_date": "2018-02-07",
"last_updated": "2023-05-08",
"certification_date": "2023-05-08",
"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": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": true
},
{
"code": "2080N0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": null,
"license": null,
"primary": false
}
],
"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": "2608 E 7th St",
"address_2": "Ste 100D",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282044375",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Atrium Health Levine Children's Neonatal Follow-up",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "CHS Neonatal Follow-up Clinic",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "CHS Neonatal Follow-up Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Charlotte, NC
- The Charlotte-Mecklenburg Hospital Authority (Levine Cancer Institute)
- The Charlotte-Mecklenburg Hospital Authority (Atrium Health Dental Clinic)
- The Charlotte-Mecklenburg Hospital Authority (Atrium Health Addiction Services Ballantyne)
- The Charlotte-Mecklenburg Hospital Authority (Atrium Health University City)
- The Charlotte-Mecklenburg Hospital Authority (Atrium Health Pineville)
- The Charlotte-Mecklenburg Hospital Authority (Levine Cancer Institute)
- The Charlotte-Mecklenburg Hospital Authority (Atrium Health Acute Care Surgery University)
- The Charlotte-Mecklenburg Hospital Authority (Atrium Health Neurology)
- The Charlotte-Mecklenburg Hospital Authority (Atrium Health AvidXchange Health Center)
- The Charlotte-Mecklenburg Hospital Authority
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.