The Charlotte-Mecklenburg Hospital Authority

Primary specialty

Surgical Oncology PhysicianTaxonomy code 2086X0206X

Legal business name

THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY

Practice address

201 E Grover St
Shelby, NC 28150-3917

Phone

(704) 355-9291

NPI assigned

Mar 30, 2012

Organization subpart

Yes

Parent organization

THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITYAs reported in NPPES

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 5

Addresses

Other names 1

• Levine Cancer Institute Doing business as

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

CLIA laboratory certificates

Part of

Charlotte Mecklenburg Hospital Authority

Locations

Practitioners 17

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

• Hana Marie Cayton, FNP

  • Family Nurse Practitioner
  • Charlotte, NC
  • NPI 1427767334
  NPD
• Tamera Beam Cox, MD

  • Surgery Physician
  • Shelby, NC
  • NPI 1538452610
  NPD
• Amy C. Croft, FNP

  • Family Nurse Practitioner
  • Shelby, NC
  • NPI 1356866362
  NPD
• Amanda Hamrick Eckenrode, MD

  • Surgery Physician
  • Shelby, NC
  • NPI 1639464720
  NPD
• Peyton Anne Lee, PA

  • Physician Assistant
  • Concord, NC
  • NPI 1770331720
  NPD
• Laura Grilla Lofland, PA

  • Physician Assistant
  • Charlotte, NC
  • NPI 1982974549
  NPD
• Haley Laura Mock, NP

  • Nurse Practitioner
  • Gastonia, NC
  • NPI 1750076238
  NPD
• Maria Garcia Moore, M.D.

  • Hematology & Oncology Physician
  • Clyde, NC
  • NPI 1306847553
  NPD
• Anna Catherine Caldwell Morris, PA

  • Physician Assistant
  • Charlotte, NC
  • NPI 1689261927
  NPD
• Danielle Renee Novak, PA

  • Physician Assistant
  • Charlotte, NC
  • NPI 1225805609
  NPD
• Abigail Mairead Phelps, MD

  • Hematology & Oncology Physician
  • Shelby, NC
  • NPI 1679077077

  Internal Medicine

  NPD
• Mariette Pontes Riemann, MD

  • Emergency Medicine Physician
  • Charlotte, NC
  • NPI 1982637468
  NPD

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1629344940",
    "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": "201 E GROVER ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503917",
            "telephone_number": "704-355-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
        "enumeration_date": "2012-03-30",
        "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": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "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": "201 E Grover St",
            "city": "Shelby",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281503917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Levine Cancer Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Levine Cancer Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tsimmeng Justin Thao, DO
• The Avalib Care Cart, PLLC
• The Charlotte-Mecklenburg Hospital Authority
• The Charlotte-Mecklenburg Hospital Authority
• The Charlotte-Mecklenburg Hospital Authority
• The Charlotte-Mecklenburg Hospital Authority
• The Charlotte-Mecklenburg Hospital Authority
• The Creek Consulting
• The Kid Guru, LLC
• Thome & Zimmer DDS PLLC I

• Surgical Oncology Physician in Shelby, NC
• Providers in Shelby, NC by specialty
• Surgical Oncology Physician in North Carolina

• 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.

Verify at the official NPI Registry.