NPIMap

Organization Active NPI

The Charlotte-Mecklenburg Hospital Authority

Doing business as Atrium Health Behavioral Health Psychiatry & Counseling

  • Child & Adolescent Psychiatry Physician
  • Albemarle, NC
National Provider Identifier
1710314133
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
Doing business as
Atrium Health Behavioral Health Psychiatry & Counseling
NorthEast Psychiatric Services - Albemarle
Practice address
923 N 2ND St
Ste 105
Albemarle, NC 28001-3317
Phone
(704) 403-1877
NPI assigned
Sep 30, 2013
Last updated
Mar 9, 2023By the provider in NPPES
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU
Child & Adolescent Psychiatry Physician 2084P0804X NU Primary

Addresses

Primary practice location

923 N 2ND St
Ste 105
Albemarle, NC 28001-3317

Mailing address

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

Other names 2

  • Atrium Health Behavioral Health Psychiatry & Counseling Doing business as
  • NorthEast Psychiatric Services - Albemarle Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Ambulatory@direct.carolinashealthcare.org Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

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

National Provider Directory
Tax ID family
Carolinas Medical Center104 organizations share this tax ID, including this one
Part of
Carolinas Medical Center

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

Locations

105 Yadkin St
#302A
Albemarle, NC 28001
Phone (704) 403-1877

105 Yadkin St
Ste 302A
Albemarle, NC 28001

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

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": "1710314133",
    "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": "923 N 2ND ST",
            "address_2": "STE 105",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013317",
            "telephone_number": "704-403-1877"
        }
    ],
    "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": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "923 N 2nd St",
            "address_2": "Ste 105",
            "city": "Albemarle",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280013317",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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"
        }
    ],
    "other_names": [
        {
            "organization_name": "Atrium Health Behavioral Health Psychiatry & Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NorthEast Psychiatric Services - Albemarle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albemarle, NC

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.