NPIMap

Organization Active NPI

Davidson Clinic

Doing business as Atrium Health Primary Care Davidson Clinic

  • Family Medicine Physician
  • Davidson, NC
National Provider Identifier
1902837073
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DAVIDSON CLINIC
Doing business as
Atrium Health Primary Care Davidson Clinic
The Davidson Clinic
Practice address
705 Griffith St
Ste 100
Davidson, NC 28036-9304
Phone
(704) 801-7900
NPI assigned
Jul 6, 2006
Last updated
Mar 9, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
DAVIDSON CLINICAs 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
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

705 Griffith St
Ste 100
Davidson, NC 28036-9304

Mailing address

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

Other names 2

  • Atrium Health Primary Care Davidson Clinic Doing business as
  • The Davidson Clinic 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

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
34D0871836CPN, Inc Dba Atrium Health Primary Care705 Griffith Street, Suite 100, Davidson, NC 28036Certificate of waiverSep 24, 2026

National Provider Directory

National Provider Directory
Part of
The Davidson Clinic

Member of 2

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

Member organizations 77

Organizations listed as members of this organization in the National Provider Directory.

View all 77

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1902837073",
    "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": "705 GRIFFITH ST",
            "address_2": "STE 100",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280369304",
            "telephone_number": "704-801-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIDSON CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVIDSON CLINIC",
        "enumeration_date": "2006-07-06",
        "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": "",
            "desc": "Family 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": "705 Griffith St",
            "address_2": "Ste 100",
            "city": "Davidson",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280369304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Atrium Health Primary Care Davidson Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Davidson Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davidson, 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 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.