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PEDIATRIC ENDOCRINOLOGY & DIABETES SPECIALISTS
NPI 1679582134
Pediatrics - Pediatric Endocrinology in Charlotte, NC

Active since August 05, 2006CLIA 34D0702317 · Waiver
4501 CAMERON VALLEY PKWY, STE 200, CHARLOTTE, NC 28211(704) 512-3636 Get Directions Write a Review

NPPES record last updated: March 9, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Mar 9, 2023, Feb 13, 2023, Jan 18, 2023 and 36 more (39 updates tracked since 2018).

About Pediatric Endocrinology & Diabetes Specialists NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIATRIC ENDOCRINOLOGY & DIABETES SPECIALISTS (NPI 1679582134) is a healthcare organization registered as a pediatric endocrinology in Charlotte, North Carolina and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through March 10, 2027 and lists Scott Rissmiller, Enterprise Evp, as its authorized official.

NPPES Registry Identity

NPI1679582134
Entity TypeOrganization
Primary Taxonomy2080P0205X
Legal Business NamePEDIATRIC ENDOCRINOLOGY & DIABETES SPECIALISTS
Location Address4501 CAMERON VALLEY PKWY, STE 200Charlotte, NC 28211-4297
Mailing AddressPo Box 19305Charlotte, NC 28219-9305 · (704) 631-0002
Phone(704) 512-3636
Organization SubpartYes
Authorized OfficialScott RissmillerEnterprise Evp · (704) 355-8675
Enumeration DateAugust 5, 2006
Last NPPES UpdateMarch 9, 202339 updates tracked since enumeration
✔ NPI 1679582134 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric EndocrinologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0205X
Definition
A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands.
4501 CAMERON VALLEY PKWY, Charlotte, NC 28211
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Other Names 1

Doing Business AsPediatric Endocrinology & Diabetes Specialists

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D0702317

Atrium Health Children's Specialty Network, Inc Dba Pediatric Endocrinology & Diabetes Specialists · Charlotte, NC
Active · expires Mar 10, 2027
CLIA Number34D0702317
Laboratory TypePhysician Office
Certificate Effective DateMarch 11, 2025
Certificate Expiration DateMarch 10, 2027
Laboratory DirectorDr. Mark Vanderwal
Laboratory Phone(704) 512-5363
Laboratory LocationAtrium Health Children's Specialty Network, Inc Dba Pediatric Endocrinology & Diabetes Specialists4501 Cameron Valley Parkway, Suite 300, Charlotte, NC 28211
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID JERRET PUBANTZ MD
Pediatrics
4501 CAMERON VALLEY PKWY, STE 200-B
CHARLOTTE, NC 28211
Mecklenburg County (704) 381-0500
HENRY SMITH
Pediatrics
4501 CAMERON VALLEY PKWY, SUITE 100
CHARLOTTE, NC 28211
Mecklenburg County (704) 367-7400
STEPHANIE PETTUS KWON MD
Pediatrics
4501 CAMERON VALLEY PKWY, STE 100
CHARLOTTE, NC 28211
Mecklenburg County (704) 367-7400
MEDCARERX INC
Pharmacy (Community/Retail Pharmacy)
4501 CAMERON VALLEY PKWY
CHARLOTTE, NC 28211
Mecklenburg County (704) 367-7440
CAROLINAS MEDICAL CENTER-NORTHEAST
Pediatrics (Developmental - Behavioral Pediatrics)
4501 CAMERON VALLEY PKWY, SUITE 301-B
CHARLOTTE, NC 28211
Mecklenburg County (704) 403-2626
ANNA TAYLOR SCHMELZER MD
Pediatrics
4501 CAMERON VALLEY PKWY, STE 100
CHARLOTTE, NC 28211
Mecklenburg County (704) 367-7400
STEFANIE ANN KIENKER FNP
Nurse Practitioner (Family)
4501 CAMERON VALLEY PKWY, STE 300
CHARLOTTE, NC 28211
Mecklenburg County (704) 381-6255
JAKUB MIESZCZAK MD
Pediatrics (Pediatric Endocrinology)
4501 CAMERON VALLEY PKWY, STE 200
CHARLOTTE, NC 28211
Mecklenburg County (704) 512-3636

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pediatric Endocrinology & Diabetes Specialists's NPI number?

The NPI number for Pediatric Endocrinology & Diabetes Specialists is 1679582134. It was assigned to this organization in the NPPES registry on August 5, 2006.

Where is Pediatric Endocrinology & Diabetes Specialists located?

Pediatric Endocrinology & Diabetes Specialists is located at 4501 Cameron Valley Pkwy Ste 200, Charlotte, NC 28211. The listed phone number is (704) 512-3636.

What is Pediatric Endocrinology & Diabetes Specialists's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Endocrinology, with taxonomy code 2080P0205X.

Does Pediatric Endocrinology & Diabetes Specialists hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D0702317) is associated with this NPI, valid through March 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pediatric Endocrinology & Diabetes Specialists was last updated on March 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.