Individual provider Active NPI

Evan Paige Chambers

  • Speech-Language Pathologist
  • Charlotte, NC
National Provider Identifier
1396612917
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30003872 Issued in NC
Practice address
507 Wakefield Dr Apt C
Charlotte, NC 28209-3148
Phone
(704) 285-8207
NPI assigned
Oct 20, 2025
Last updated
Oct 20, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 30003872 NC Primary

Addresses

Primary practice location

507 Wakefield Dr Apt C
Charlotte, NC 28209-3148

Mailing address

507 Wakefield Dr Apt C
Charlotte, NC 28209-3148

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251113001504 NC Practitioner - Qualified Speech Language Pathologist 4981195369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4504 Providence Rd Apt
2D
Charlotte, NC 28226-4101

507 Wakefield Dr
Apt C
Charlotte, NC 28209-3148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30003872NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Collective Therapy Corp. Speech-Language Pathologist CurrentSince Oct 15, 2025 Accepting new patients

Locations

8919 Park Rd
Charlotte, NC 28210
Phone (704) 384-1225

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": "1760918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1396612917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 WAKEFIELD DR APT C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 WAKEFIELD DR APT C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093148",
            "telephone_number": "704-285-8207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "EVAN",
        "middle_name": "PAIGE",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-10-20",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30003872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.