Kamiyal Shavondar Chambers, NA

Individual provider Active NPI Nurse's Aide · Charlotte, NC

NPI 1477123701 · NPPES record last updated Jun 29, 2021

Key facts

NPI
1477123701
Entity type
Individual (NPI type 1)
Primary specialty
Nurse's Aide 376K00000X
License
330338 (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
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
330338NCMDNurse's Aide

Practice roles

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

Locations

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

Specialties & licenses

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

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

Other identifiers

IdentifierTypeStateIssuer
86-1626733MedicaidNC

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL kamiyalchambers75@gmail.com Direct

Other providers in Charlotte, NC

All providers in Charlotte, NC · Nurse's Aide in North Carolina

Sources for this page

Verify at the official NPI Registry.