Individual provider Active NPI

Chanda Nicole Guptill, NP

  • Nurse Practitioner
  • Matthews, NC
National Provider Identifier
1407005119
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5004033 Issued in NC
Practice address
332 N Trade St
Ste 1500
Matthews, NC 28105-1728
Phone
(704) 512-6820
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 16737 WI
Nurse Practitioner 363L00000X 209-031918 IL
Nurse Practitioner 363L00000X 5004033 NC Primary

Addresses

Primary practice location

332 N Trade St
Ste 1500
Matthews, NC 28105-1728

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

14555 W National Ave
New Berlin, WI 53151-4494
Phone (844) 284-0381

Other practice location 2

231 S Sharon Amity Rd
Charlotte, NC 28211-2803
Phone (704) 304-6400

Other practice location 3

4501 Cameron Valley Pkwy
Ste 100
Charlotte, NC 28211-4297
Phone (704) 367-7400

Other practice location 4

13640 Steelecroft Pkwy
Ste 210
Charlotte, NC 28278-7565
Phone (704) 512-6100

Other practice location 5

6235 Blakeney Park Dr
Ste 100
Charlotte, NC 28277-5658
Phone (704) 512-5060

Other practice location 6

1441 Branding Ave Ste 310
Downers Grove, IL 60515-5624
Phone (708) 634-0950

Other identifiers 1

IdentifierTypeStateIssuer
100325202MedicaidWI

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address cguptill427482@direct.myadvocateaurora.org Direct
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address cguptill128417@CarolinasHealthcareSystem.direct-ci.com Atrium Health
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, IL, WI, GA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20121011000009 NC Practitioner - Nurse Practitioner 5193974921 Reassigns benefits to 1 organization
I20250519002641 IL Practitioner - Nurse Practitioner 5193974921 Reassigns benefits to 1 organization
I20250604001077 WI Practitioner - Nurse Practitioner 5193974921 Reassigns benefits to 1 organization
I20251008003642 GA Practitioner - Nurse Practitioner 5193974921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

420 E 2ND Ave
Suite 103
Rome, GA 30161-3210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
16737WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Mar 9, 2025 Accepting new patients
Charlotte Pediatric Clinic CurrentSince Nov 24, 2019 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 1, 2012 Accepting new patients
Floyd Healthcare Management Inc CurrentSince Aug 1, 2025 Accepting new patients
Floyd Healthcare Management Inc CurrentSince Aug 1, 2025 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 23, 2025 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Mar 9, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 1, 2012 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 23, 2025 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Carolinas Physicians Network Inc PastSince Sep 25, 2016 Accepting new patients

Locations

1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212

990 Veterans Memorial Hwy NE
#A
Rome, GA 30161
Phone (706) 291-4100

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

1441 Branding Ave
Ste 310
Downers Grove, IL 60515
Phone (630) 829-1038

1441 Branding Ave
Ste 200
Downers Grove, IL 60515
Phone (630) 829-1084

100 N 6th St
Ste 900A
Minneapolis, MN 55403

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

4501 Cameron Valley Pkwy
Ste 100
Charlotte, NC 28211
Phone (704) 367-7400

231 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 304-6400

13640 Steelecroft Pkwy
Ste 210
Charlotte, NC 28278
Phone (704) 512-6100

6235 Blakeney Park Dr
Ste 100
Charlotte, NC 28277
Phone (704) 512-5060

332 N Trade St
Ste 1500
Matthews, NC 28105
Phone (704) 512-6820

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

14555 W National Ave
Ste 140
New Berlin, WI 53151
Phone (262) 827-0480

Interoperability endpoints

  • Direct secure messaging: cguptill427482@direct.myadvocateaurora.org
  • Direct secure messaging: cguptill128417@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1407005119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 N TRADE ST",
            "address_2": "STE 1500",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281051728",
            "telephone_number": "704-512-6820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14555 W National Ave",
            "address_purpose": "LOCATION",
            "city": "New Berlin",
            "state": "WI",
            "postal_code": "531514494",
            "country_code": "US",
            "telephone_number": "844-284-0381",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "231 S Sharon Amity Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282112803",
            "country_code": "US",
            "telephone_number": "704-304-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4501 Cameron Valley Pkwy",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114297",
            "country_code": "US",
            "telephone_number": "704-367-7400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13640 Steelecroft Pkwy",
            "address_2": "Ste 210",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282787565",
            "country_code": "US",
            "telephone_number": "704-512-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6235 Blakeney Park Dr",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282775658",
            "country_code": "US",
            "telephone_number": "704-512-5060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1441 Branding Ave Ste 310",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605155624",
            "country_code": "US",
            "telephone_number": "708-634-0950",
            "fax_number": "708-634-0942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTILL",
        "first_name": "CHANDA",
        "middle_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "16737",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-031918",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100325202",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cguptill427482@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1441 Branding Ave Ste 310",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605155624",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cguptill128417@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "332 N Trade St",
            "address_2": "Ste 1500",
            "city": "Matthews",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281051728",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1441 Branding Ave Ste 310",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605155624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.