Individual provider Active NPI

Kamiyal Shavondar Chambers, NA

  • Nurse's Aide
  • Charlotte, NC
National Provider Identifier
1477123701
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
330338 Issued in NC
Practice address
7701 Creekridge Rd Apt 1005
Charlotte, NC 28212-0175
Phone
(980) 447-3070
Fax
(704) 448-2080
NPI assigned
Jun 29, 2021
Last updated
Jun 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 330338 NC Primary

Addresses

Primary practice location

7701 Creekridge Rd Apt 1005
Charlotte, NC 28212-0175

Mailing address

4919 Albemarle Rd Ste 105
Charlotte, NC 28205-6653
Phone (980) 447-3070

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL kamiyalchambers75@gmail.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
330338NCMDNurse's Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Aa & Q Transportation Inc, CurrentSince Jul 4, 2021 Accepting new patients

Locations

4919 Albemarle Rd
Ste 105
Charlotte, NC 28205
Phone (980) 447-3070

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": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1477123701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4919 ALBEMARLE RD STE 105",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282056653",
            "telephone_number": "980-447-3070",
            "fax_number": "704-448-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 CREEKRIDGE RD APT 1005",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282120175",
            "telephone_number": "980-447-3070",
            "fax_number": "704-448-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "KAMIYAL",
        "middle_name": "SHAVONDAR",
        "credential": "NA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NC",
            "license": "330338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kamiyalchambers75@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email address is  private and safe to receive Healthcare Information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7701 Creekridge Rd Apt 1005",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282120175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.