MEDICARE: ATRIUM HEALTH SPECIALTY NETWORK INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	235Z00000X	Speech-Language Pathologist
2	225100000X	Physical Therapist
3	207R00000X	Internal Medicine Physician
4	2084P0800X	Psychiatry Physician
5	207RC0000X	Cardiovascular Disease Physician
6	207RR0500X	Rheumatology Physician
7	225X00000X	Occupational Therapist
8	207RT0003X	Transplant Hepatology Physician
9	207Q00000X	Family Medicine Physician
10	208100000X	Physical Medicine & Rehabilitation Physician
11	207RI0008X	Hepatology Physician
12	208VP0000X	Pain Medicine Physician
13	207RI0200X	Infectious Disease Physician
14	207RG0100X	Gastroenterology Physician
15	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1538975636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATRIUM HEALTH SPECIALTY NETWORK INC

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	:	10650 PARK RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-8538
Country	:	US
Telephone Number	:	704-667-0340
Fax Number	:

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

Provider Enumeration Date	:	12/04/2024
Last Update Date	:	06/04/2026

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Directions to “ATRIUM HEALTH SPECIALTY NETWORK INC ” Practice Location

Language	Start Address	Practice Location

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