NPIMap

Organization Active NPI

Carolinas Medical Center

Doing business as Atrium Health Levine Children's Gastroenterology

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
National Provider Identifier
1275774333
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
CAROLINAS MEDICAL CENTER
Doing business as
Atrium Health Levine Children's Gastroenterology
CMC Faculty Physicians
Practice address
1350 S Kings Dr
Charlotte, NC 28207-2134
Phone
(704) 446-1544
NPI assigned
Mar 18, 2009
Last updated
Sep 18, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROLINAS MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Scott Rissmiller
Title
President
Phone
(704) 631-0002

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Maternal & Fetal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VM0101X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Pediatric Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0206X

Addresses

Primary practice location

1350 S Kings Dr
Charlotte, NC 28207-2134

Mailing address

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

Other practice location 1

1935 Holbrook Rd
Fort Mill, SC 29715-9675
Phone (704) 381-6850

Other practice location 2

11530 Providence Rd
Charlotte, NC 28277-2691
Phone (704) 381-6850

Other names 2

  • Atrium Health Levine Children's Gastroenterology Doing business as
  • CMC Faculty Physicians Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
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 IDStateProvider typePAC IDDetails
O20031110000116 NC Part B Supplier - Clinic/Group Practice 4789597477 Receives reassigned benefits from 2,635 practitioners
30 other NPIs on this enrollment

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 30

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

View all 30

National Provider Directory

National Provider Directory
Part of
CMC Randloph

Locations

1025 Morehead Medical Dr
Ste 450
Charlotte, NC 28204
Phone (704) 446-7800

13640 Steelecroft Pkwy
Ste 240
Charlotte, NC 28278
Phone (704) 512-2860

1801 Rozzelles Ferry Rd
Charlotte, NC 28208
Phone (704) 446-9987

2101 Sardis Rd N
Ste 220
Charlotte, NC 28227
Phone (704) 841-1163

13620 Reese Blvd E
Huntersville, NC 28078
Phone (704) 801-7330

Practitioners & affiliated clinicians

Practitioners 2,688

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.

View all 2,688

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789689600000",
    "number": "1275774333",
    "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": "1350 S KINGS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072134",
            "telephone_number": "704-446-1544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1935 Holbrook Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Mill",
            "state": "SC",
            "postal_code": "297159675",
            "country_code": "US",
            "telephone_number": "704-381-6850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11530 Providence Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282772691",
            "country_code": "US",
            "telephone_number": "704-381-6850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAROLINAS MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS MEDICAL CENTER",
        "enumeration_date": "2009-03-18",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A",
        "authorized_official_last_name": "RISSMILLER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-631-0002"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1350 S Kings Dr",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282072134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Atrium Health Levine Children's Gastroenterology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CMC Faculty Physicians",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CMC Faculty Physicians",
            "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 Sep 18, 2026; 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.

Verify at the official NPI Registry.