CHARLOTTE PEDIATRIC CLINIC NPI 1780911339

NPI Information

  • NPI: 1780911339
  • Provider Name: CHARLOTTE PEDIATRIC CLINIC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • Doing Business As: CHARLOTTE PEDIATRIC CLINIC
  • CLIA Number: 34D1107483
  • Address: 13640 STEELECROFT PKWY
    STE 210
    CHARLOTTE, NC
    ZIP 28278
  • Phone: (704) 512-6100

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NPI Details

CHARLOTTE PEDIATRIC CLINIC is a pediatrics in Charlotte, NC. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. CHARLOTTE PEDIATRIC CLINIC NPI is 1780911339. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Charlotte Pediatric Clinic.

The provider's business location address is:

13640 STEELECROFT PKWY
STE 210
CHARLOTTE, NC
ZIP 28278-565
Phone: (704) 512-6100

The provider's authorized official is Scott Rissmiller .
The authorized official title is Enterprise Evp and has the following contact phone number (704) 355-8675.

The CLIA number assigned to this NPI record is 34D1107483 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/3/2009 and was last updated on 3/9/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsYes

What is NPI?

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This page was last updated on: 11/21/2025

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