KINGS MOUNTAIN INTERNAL MEDICINE
NPI 1063854057
Internal Medicine in Kings Mountain, NC

NPI Status: Active since July 19, 2013

Contact Information

2202 CAROLINA PL
STE 100
KINGS MOUNTAIN, NC
ZIP 28086
Phone: (980) 487-2290

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  • Organization
  • Internal Medicine
  • Accepts Insurance
  • CLIA Number: 34D1106171
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 10-06-2027

About KINGS MOUNTAIN INTERNAL MEDICINE

This page provides the complete NPI Profile along with additional information for Kings Mountain Internal Medicine, an internist established in Kings Mountain, North Carolina operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1063854057 assigned on July 2013. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Kings Mountain Internal Medicine. The authorized official of this NPI record is Scott Rissmiller (Enterprise Evp)

NPI
1063854057
Provider Legal Name
CAROLINAS PHYSICIANS NETWORK INC
Other Organization Name
KINGS MOUNTAIN INTERNAL MEDICINE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
2202 CAROLINA PL STE 100 KINGS MOUNTAIN, NC 28086
Location Phone
(980) 487-2290
Mailing Address
PO BOX 19305 CHARLOTTE, NC 28219
Mailing Phone
(704) 631-0002
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
07-19-2013
Last Update Date
03-09-2023
Code Navigator

An internist like Kings Mountain Internal Medicine is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Gold - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
  • Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors - PPO
  • Blue Advantage Bronze Standard | Nationwide Doctors - PPO
  • Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Gold Standard A | Nationwide Doctors - PPO
  • Blue Advantage Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
  • Blue Advantage Silver Standard | Nationwide Doctors - PPO
  • Blue Care Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Statewide Doctors - HMO
  • Blue Direction Bronze 1 - POS
  • Blue Direction Silver 1 - POS
  • Blue Direction Silver 1 + Adult Vision - POS
  • Blue Direction Silver 2 - POS
  • Blue Direction Standard Expanded Bronze - POS
  • Blue Direction Standard Gold - POS
  • Blue Direction Standard Silver - POS
  • Blue VirtuConnect Bronze 1 - EPO
  • Blue VirtuConnect Gold 1 - EPO
  • Blue VirtuConnect Silver 1 - EPO
  • InHealth Basic 1 - HMO
  • InHealth Basic 1 + Adult Vision - HMO
  • InHealth Basic 2 - HMO
  • InHealth Basic Plus Standard - HMO
  • InHealth Basic Standard - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

SCOTT RISSMILLER

Authorized Official Title
ENTERPRISE EVP
Authorized Official Phone
(704) 355-8675

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
34D1106171
Facility Type
Physician Office
Certificate Effective Date
October 07, 2025
Certificate Expiration Date
October 06, 2027
Laboratory Director
LAURENCE M. KISH
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Kings Mountain Internal Medicine to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1063854057, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
3
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
5
Unchanged
Pos 7
4
Doubled → 8
Pos 8
0
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 8 → 16 → 7 4 → 8 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 2 + 3 + 1 + 6 + 5 + 8 + 0 + 1 + 0 + 24 = 53

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1063854057.

Other Providers at the Same Location


The following 6 providers are registered at the same or a nearby location.

Internal Medicine
2202 CAROLINA PL, STE 100
KINGS MOUNTAIN, NC 28086
Pediatrics
2202 CAROLINA PL, STE 200
KINGS MOUNTAIN, NC 28086
Physician Assistant
2202 CAROLINA PL, STE 100
KINGS MOUNTAIN, NC 28086
Internal Medicine
2202 CAROLINA PL, STE 100
KINGS MOUNTAIN, NC 28086
Family Medicine
2202 CAROLINA PL, STE 100
KINGS MOUNTAIN, NC 28086
Pediatrics
2202 CAROLINA PL, STE 200
KINGS MOUNTAIN, NC 28086

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1063854057, enumerated as an "organization" on July 19, 2013.

The provider is located at 2202 CAROLINA PL STE 100 KINGS MOUNTAIN, NC 28086 and the phone number is (980) 487-2290.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.