Individual provider Active NPI

Chandler Reid Halvorsen

  • Physician Assistant
  • Concord, NC
National Provider Identifier
1285598805
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
202D McGill Ave NW
Concord, NC 28025-4615
Phone
(704) 792-2315
NPI assigned
Dec 10, 2025
Last updated
Aug 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NC Primary

Addresses

Primary practice location

202D McGill Ave NW
Concord, NC 28025-4615

Mailing address

202D McGill Ave NW
Concord, NC 28025-4615
Phone (704) 792-2315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260521002638 NC Practitioner - Physician Assistant 7113497918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

298 Lincoln St SW
Concord, NC 28025-5469
Phone (704) 792-2242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1765324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1285598805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202D MCGILL AVE NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254615",
            "telephone_number": "704-792-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202D MCGILL AVE NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254615",
            "telephone_number": "704-792-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVORSEN",
        "first_name": "CHANDLER",
        "middle_name": "REID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-10",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.