Active NPI
Chanda N Roberts, SLP
- Speech-Language Pathologist
- Hickory, NC
National Provider Identifier
1699831479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12093249
- Practice address
- 810 Fairgrove Church Rd
Hickory, NC 28602-9617 - Phone
- (828) 326-3809
- Fax
- (828) 326-3371
- NPI assigned
- Dec 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 12093249 | NC | Primary |
Addresses
Primary practice location
810 Fairgrove Church Rd
Hickory, NC 28602-9617
Mailing address
177 Pinecrest CT
Taylorsville, NC 28681-3830
Phone (828) 326-3809
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 144P3 | Other | NC | NC BCBS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12093249 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699831479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "177 PINECREST CT",
"city": "TAYLORSVILLE",
"state": "NC",
"postal_code": "286813830",
"telephone_number": "828-326-3809",
"fax_number": "828-326-3371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 FAIRGROVE CHURCH RD",
"city": "HICKORY",
"state": "NC",
"postal_code": "286029617",
"telephone_number": "828-326-3809",
"fax_number": "828-326-3371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "CHANDA",
"middle_name": "N",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "12093249",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC BCBS",
"identifier": "144P3",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hickory, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.