Active NPI
South Charlotte Primary Care
- Family Medicine Physician
- Charlotte, NC
National Provider Identifier
1619904430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- SOUTH CHARLOTTE PRIMARY CARE
- Practice address
- 7030 Pineville Matthews Rd
Charlotte, NC 28226-8298 - Phone
- (704) 667-4150
- NPI assigned
- Jun 27, 2006
- Organization subpart
- Yes
- Parent organization
- SOUTH CHARLOTTE PRIMARY CARE
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
7030 Pineville Matthews Rd
Charlotte, NC 28226-8298
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Phone (704) 631-0002
Other names 2
- Atrium Health Primary Care South Charlotte Internal Medicine
- South Charlotte Primary Care
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 |
National Provider Directory
National Provider Directory- Part of
- South Charlotte Primary Care
Member of 2
Organizations this organization is a member of, according to the National Provider Directory.
-
- Preventive Medicine/Occupational Environmental Medicine Physician
- Charlotte, NC
- NPI 1396886099
Member Of
-
- Orthopaedic Surgery Physician
- Denver, NC
- NPI 1477884302
Member Of
Locations
7030 Pineville Matthews Rd
Charlotte, NC 28226
Phone (704) 344-2100
920 Church St N
Concord, NC 28025
Phone (704) 403-3000
Practitioners & affiliated clinicians
Practitioners 1
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": "1151366400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678320000000",
"number": "1619904430",
"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": "7030 PINEVILLE MATTHEWS RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282268298",
"telephone_number": "704-667-4150"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTH CHARLOTTE PRIMARY CARE",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SOUTH CHARLOTTE PRIMARY CARE",
"enumeration_date": "2006-06-27",
"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": "7030 Pineville Matthews Rd",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282268298",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Atrium Health Primary Care South Charlotte Internal Medicine",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "South Charlotte Primary Care",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Charlotte, NC
- South Charlotte Dermatology, PC
- South Charlotte General and Vascular Surgery PLLC
- South Charlotte Pain Relief Center, Inc.
- South Charlotte Pediatrics, PLLC
- South Charlotte Physical Therapy LLC
- South Charlotte Rheumatology, PLLC
- South Charlotte Rheumatology, PLLC
- South East Mecklenburg County Health Department
- South Fork Optometric Associates, P.a.
- South Lake Pediatrics
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.