Active NPI
The Charlotte-Mecklenburg Hospital Authority
Doing business as Atrium Health Employer Solutions Care
- Family Medicine Physician
- Concord, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
- Doing business as
- Atrium Health Employer Solutions Care
Atrium Health Primary Care Edison Square Family Medicine
Edison Square Family Medicine - Practice address
- 10030 Edison Square Dr NW
Ste 100
Concord, NC 28027-8308 - Phone
- (704) 403-7830
- NPI assigned
- Sep 27, 2013
- Last updated
- Mar 9, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
10030 Edison Square Dr NW
Ste 100
Concord, NC 28027-8308
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Phone (704) 631-0002
Other practice location 1
4135 Southstream Blvd
Charlotte, NC 28217-4523
Phone (704) 631-1200
Other names 3
- Atrium Health Employer Solutions Care
- Atrium Health Primary Care Edison Square Family Medicine
- Edison Square Family Medicine
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 |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D0963416 | Atrium Health Primary Care Edison Square | Provider-performed microscopy | Sep 10, 2026 |
National Provider Directory
National Provider Directory- Part of
- Charlotte Mecklenburg Hospital Authority
Locations
1025 Morehead Medical Dr
#3
Charlotte, NC 28204
Practitioners & affiliated clinicians
Practitioners 8
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.
-
- Primary Care Clinic/Center
- Charlotte, NC
- NPI 1538140694
-
- Family Medicine Physician
- Charlotte, NC
- NPI 1033196399
-
- Family Nurse Practitioner
- Belmont, NC
- NPI 1255853701
-
- Family Nurse Practitioner
- Shelby, NC
- NPI 1881792752
-
- Nurse Practitioner
- Charlotte, NC
- NPI 1407894835
-
- Obstetrics & Gynecology Physician
- Concord, NC
- NPI 1700915873
-
- Nurse Practitioner
- Mooresville, NC
- NPI 1598702896
-
- Family Nurse Practitioner
- Huntersville, NC
- NPI 1487905329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380240000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678320000000",
"number": "1366879934",
"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": "10030 EDISON SQUARE DR NW",
"address_2": "STE 100",
"city": "CONCORD",
"state": "NC",
"postal_code": "280278308",
"telephone_number": "704-403-7830"
}
],
"practiceLocations": [
{
"address_1": "4135 Southstream Blvd",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282174523",
"country_code": "US",
"telephone_number": "704-631-1200",
"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": "2013-09-27",
"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": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"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": "4135 Southstream Blvd",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282174523",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Atrium Health Employer Solutions Care",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Atrium Health Primary Care Edison Square Family Medicine",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Edison Square Family Medicine",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Concord, NC
- The Charlotte-Mecklenburg Hospital Authority (Atrium Health Cabarrus)
- The Charlotte-Mecklenburg Hospital Authority (NorthEast Pediatric Pulmonology)
- The Charlotte-Mecklenburg Hospital Authority (Atrium Health Primary Care Concord Internal Medicine)
- The Charlotte-Mecklenburg Hospital Authority (Christopherson Family Medicine)
- The Charlotte-Mecklenburg Hospital Authority (Carolinas Medical Center-NorthEast)
- The Charlotte-Mecklenburg Hospital Authority (Concord Women's Specialty Care)
- The Charlotte-Mecklenburg Hospital Authority (NorthEast Neurology-Copperfield)
- The Charlotte-Mecklenburg Hospital Authority (Atrium Health Levine Children's Neurology)
- The Charlotte-Mecklenburg Hospital Authority (Atrium Health Levine Children's Jeff Gordon Children's Center)
- The Charlotte-Mecklenburg Hospital Authority (Atrium Health Cabarrus)
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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.