NPIMap

Organization Active NPI

Carolinas Physicians Network Inc

Doing business as Atrium Health Primary Care North Charlotte Internal Medicine

  • Internal Medicine Physician
  • Huntersville, NC
National Provider Identifier
1730362641
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CAROLINAS PHYSICIANS NETWORK INC
Doing business as
Atrium Health Primary Care North Charlotte Internal Medicine
North Charlotte Medical Specialist
Practice address
16455 Statesville Rd
Ste 360
Huntersville, NC 28078-7135
Phone
(704) 801-3300
NPI assigned
Dec 13, 2007
Last updated
Mar 9, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROLINAS PHYSICIANS NETWORK INCAs 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
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

16455 Statesville Rd
Ste 360
Huntersville, NC 28078-7135

Mailing address

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

Other names 2

  • Atrium Health Primary Care North Charlotte Internal Medicine Doing business as
  • North Charlotte Medical Specialist 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 NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031219000455 NC Part B Supplier - Clinic/Group Practice 3375449655 Receives reassigned benefits from 1,949 practitioners
This NPI is an additional NPI on the enrollment

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
34D0950394CPN, Dba Atrium Health Primary Care North16455 Statesville Rd, Huntersville, NC 28078Certificate of waiverMar 30, 2028
34D0957412Atrium Health Womens Care North Charlotte16455 Statesville Road, Suite 400, Huntersville, NC 28078Provider-performed microscopyFeb 18, 2027

National Provider Directory

National Provider Directory
Part of
Carolinas Physicians Network Inc

Member of 20

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

View all 20

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1730362641",
    "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": "16455 STATESVILLE RD",
            "address_2": "STE 360",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787135",
            "telephone_number": "704-801-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "enumeration_date": "2007-12-13",
        "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": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "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": "16455 Statesville Rd",
            "address_2": "Ste 360",
            "city": "Huntersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280787135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Atrium Health Primary Care North Charlotte Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Charlotte Medical Specialist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntersville, 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.
  • 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.