The Charlotte-Mecklenburg Hospital Authority

Organization Active NPI Gynecology Physician · Concord, NC

NPI 1588091177 · NPPES record last updated Mar 9, 2023

Key facts

NPI
1588091177
Entity type
Organization (NPI type 2)
Primary specialty
Gynecology Physician 207VG0400X
Legal business name
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
Practice address
10030 Edison Square Dr NW
Ste 100a
Concord, NC 28027-8308
Phone
(704) 403-7670
NPI assigned
Sep 27, 2013
Organization subpart
Yes
Parent organization (as reported)
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY

Authorized official

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

Practitioners 16

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2107398Cmha Dba Atrium Health Women'S Care GYN
10030 Edison Square Drive Northwest, Concord, NC 28027
Provider-performed microscopyJan 11, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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

Part of
Charlotte Mecklenburg Hospital Authority

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207VG0400X Yes

Addresses

Primary practice location

10030 Edison Square Dr NW
Ste 100a
Concord, NC 28027-8308

Mailing address

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

Other names

  • Atrium Health Women's Care GYN of the Carolinas Doing business as
  • GYN Care of the Carolinas Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
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

Other providers in Concord, NC

All providers in Concord, NC · Gynecology Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.