NPIMap

Organization Active NPI

Carolinas Physicians Network Inc.

Doing business as Atrium Health Imaging - Kenilworth

  • Vascular Surgery Physician
  • Charlotte, NC
National Provider Identifier
1881624807
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
CAROLINAS PHYSICIANS NETWORK INC.
Doing business as
Atrium Health Imaging - Kenilworth
Atrium Health Levine Children's Congenital Heart Center
The Sanger Clinic
Practice address
1237 Harding PL
Ste 3100
Charlotte, NC 28204
Phone
(704) 373-0212
NPI assigned
Jul 4, 2006
Last updated
Nov 10, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROLINAS PHYSICIANS NETWORK INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Scott Rissmiller
Title
President
Phone
(704) 631-0002

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Surgical Physician Assistant 363AS0400X
Acute Care Nurse Practitioner 363LA2100X
Adult Health Nurse Practitioner 363LA2200X
Family Nurse Practitioner 363LF0000X
Pediatric Nurse Practitioner 363LP0200X
Registered Dietitian 133V00000X
Cardiovascular Disease Physician 207RC0000X
Clinical Cardiac Electrophysiology Physician 207RC0001X
Interventional Cardiology Physician 207RI0011X
Pediatric Cardiology Physician 2080P0202X
Pediatric Surgery Physician 2086S0120X
Vascular Surgery Physician 2086S0129X Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X

Addresses

Primary practice location

1237 Harding PL
Ste 3100
Charlotte, NC 28204

Mailing address

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

Other practice location 1

1020 Tree Of Life Ln
Cornelius, NC 28031-9454
Phone (704) 801-8210

Other practice location 2

11530 Providence Rd
Charlotte, NC 28277-2691
Phone (704) 373-1813

Other practice location 3

5 Vanderbilt Park Dr
Asheville, NC 28803-1700
Phone (704) 373-1813

Other practice location 4

1237 Harding Pl
Ste 4200
Charlotte, NC 28204
Phone (704) 373-0212

Other practice location 5

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203-5866
Phone (704) 373-0212

Other practice location 6

1237 Harding Pl
Ste 4400
Charlotte, NC 28204
Phone (704) 373-0212

Other practice location 7

15110 John J Delaney Dr
Ste 200
Charlotte, NC 28277-3544
Phone (704) 373-0212

Other names 3

  • Atrium Health Imaging - Kenilworth Doing business as
  • Atrium Health Levine Children's Congenital Heart Center Doing business as
  • The Sanger Clinic 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 SC, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031209000106 SC Part B Supplier - Clinic/Group Practice 3375449655 Receives reassigned benefits from 359 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rock Hill, SC; Fort Mill, SC; Lancaster, SC; Indian Land, SC; Greenville, SC
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

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Part of
Carolinas Physicians Network Inc

Locations

1237 Harding Pl
Ste 3100
Charlotte, NC 28204

1237 Harding Pl
Ste 4200
Charlotte, NC 28204

1237 Harding Pl
Ste 4300
Charlotte, NC 28204

15110 John J Delaney Dr
Ste 200
Charlotte, NC 28277
Phone (704) 302-8100

990 Lee Ann Dr NE
Concord, NC 28025
Phone (704) 441-0272

Practitioners & affiliated clinicians

Practitioners 199

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 199

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1881624807",
    "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": "1237 HARDING PL",
            "address_2": "STE 3100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "704-373-0212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 Tree Of Life Ln",
            "address_purpose": "LOCATION",
            "city": "Cornelius",
            "state": "NC",
            "postal_code": "280319454",
            "country_code": "US",
            "telephone_number": "704-801-8210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11530 Providence Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282772691",
            "country_code": "US",
            "telephone_number": "704-373-1813",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 Vanderbilt Park Dr",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288031700",
            "country_code": "US",
            "telephone_number": "704-373-1813",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 4200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28204",
            "country_code": "US",
            "telephone_number": "704-373-0212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Blythe Blvd",
            "address_2": "Ste 500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035866",
            "country_code": "US",
            "telephone_number": "704-373-0212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 4400",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28204",
            "country_code": "US",
            "telephone_number": "704-373-0212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15110 John J Delaney Dr",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773544",
            "country_code": "US",
            "telephone_number": "704-373-0212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAROLINAS PHYSICIANS NETWORK INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "enumeration_date": "2006-07-04",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A",
        "authorized_official_last_name": "RISSMILLER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-631-0002"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1001 Blythe Blvd",
            "address_2": "Ste 500",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282035866",
            "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 Imaging - Kenilworth",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Atrium Health Imaging - Kenilworth",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Atrium Health Levine Children's Congenital Heart Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Sanger Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; 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.