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	207Q00000X	Family Medicine Physician
5	208100000X	Physical Medicine & Rehabilitation Physician
6	207RI0008X	Hepatology Physician
7	208VP0000X	Pain Medicine Physician
8	207RI0200X	Infectious Disease Physician
9	2084P0800X	Psychiatry Physician
10	207RC0000X	Cardiovascular Disease Physician
11	207RR0500X	Rheumatology Physician
12	225X00000X	Occupational Therapist
13	207RT0003X	Transplant Hepatology 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	:	04/07/2026

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Directions to “ATRIUM HEALTH SPECIALTY NETWORK INC ” Practice Location

Language	Start Address	Practice Location

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