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NPI Code Detail

MEDICARE: THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY

MEDICARE: THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry
21223S0112XOral and Maxillofacial Surgery (Dentist)
31223P0700XProsthodontics
41223G0001XGeneral Practice Dentistry
5122300000XDentist

General Provider Information

NPI Number : 1114380698
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
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 : 1000 BLYTHE BLVD
Second Line : ANNEX BLDG 2ND FLOOR
City : CHARLOTTE
State : NC
Zip : 28203-5812
Country : US
Telephone Number : 704-355-2165
Fax Number :
Authorized Official
Title or Position : ENTERPRISE EVP
Name : SCOTT RISSMILLER
Credential :
Telephone Number : 704-355-8675
Provider Enumeration Date : 04/01/2016
Last Update Date : 05/26/2026

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Directions to “THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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