MEDICARE: ATRIUM HEALTH NORTH MARKET NETWORK LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207P00000X	Emergency Medicine Physician
2	207R00000X	Internal Medicine Physician
3	207V00000X	Obstetrics & Gynecology Physician
4	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1871112920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATRIUM HEALTH NORTH MARKET NETWORK LLC

Provider Business Mailing Address
First Line	:	PO BOX 19305
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28219-9305
Country	:	US
Telephone Number	:	704-631-0002
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 PROFESSIONAL PARK DR
Second Line	:
City	:	MOORESVILLE
State	:	NC
Zip	:	28117-5524
Country	:	US
Telephone Number	:	704-631-0002
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SCOTT C RISSMILLER
Credential	:
Telephone Number	:	704-631-0002

Provider Enumeration Date	:	04/09/2020
Last Update Date	:	06/24/2026

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