NPIMap

Organization Active NPI

The Charlotte-Mecklenburg Hospital Authority

  • Pediatrics Physician
  • Concord, NC
National Provider Identifier
1588091904
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
Practice address
1085 NE Gateway CT NE
Ste 290
Concord, NC 28025-2406
Phone
(704) 403-4650
NPI assigned
Sep 30, 2013
Organization subpart
Yes
Parent organization
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1085 NE Gateway CT NE
Ste 290
Concord, NC 28025-2406

Mailing address

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

Other names 2

  • Atrium Health Levine Children's Piedmont Pediatrics Doing business as
  • Piedmont Pediatrics Doing business as

Electronic endpoints 2

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

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
O20201208000409 NC DME Supplier - Physician - General Practice 2961310685 Practice locations: Concord, NC

Other NPIs with the same Medicare PAC ID 5

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2335420Atrium Health Levine Children'S Pediatric1085 NE Gateway CT NE, Concord, NC 28025RegistrationDec 10, 2027

National Provider Directory

National Provider Directory
Tax ID family
Charlotte Mecklenburg Hospital Authority103 organizations share this tax ID, including this one
Part of
Charlotte Mecklenburg Hospital Authority

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Carolinas Medical CenterCharlotte, NC, CCN 340113 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Nov 7, 2007
Nov 7, 2007
Levine Children'S Hospital PediatricsCharlotte, NC, CCN 34T113 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Nov 7, 2007
Nov 7, 2007
Scotland Memorial Hospital, IncLaurinburg, NC, CCN 34T008 Hospital Operational/Managerial Control Apr 1, 2009
Jesse Helms Nursing CenterMonroe, NC, CCN 345097 Skilled nursing facility Adp of the SNF Feb 1, 2020
Atrium Health at Home LincolnLincolnton, NC, CCN 347191 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jul 1, 2009
Jul 1, 2009
Atrium Health at Home CharlotteCharlotte, NC, CCN 347112 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Nov 16, 2007
Jul 1, 2009
Atrium Health at Home StanlyAlbemarle, NC, CCN 347113 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Nov 16, 2007
Jul 1, 2009
Atrium Health at Home UnionMonroe, NC, CCN 347210 Home health agency 5% Or Greater Direct Ownership Interest (100%) Nov 16, 2007
Atrium Health Floyd Medical Center Heyman Hospice CareRome, GA, CCN 111524 Hospice 5% Or Greater Indirect Ownership Interest (100%) Jul 14, 2021
Atrium Health Hospice Union; Atrium Health Hospice AnsonMonroe, NC, CCN 341513 Hospice 5% Or Greater Indirect Ownership Interest (100%) Jan 12, 2011

Owned or controlled facilities with NPI records 14

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 14

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1588091904",
    "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": "1085 NE GATEWAY CT NE",
            "address_2": "STE 290",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252406",
            "telephone_number": "704-403-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
        "enumeration_date": "2013-09-30",
        "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": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "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": "1085 NE Gateway Ct NE",
            "address_2": "Ste 290",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Atrium Health Levine Children's Piedmont Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Piedmont Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.