Individual provider Active NPI

Charissa Roberts

  • Occupational Therapist
  • Plainfield, IN
National Provider Identifier
1831587534
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31005423A Issued in IN
Practice address
9050 Anthem Ave
Plainfield, IN 46168-4936
Phone
(317) 742-5055
Fax
(317) 800-6815
NPI assigned
Jan 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31005423A IN Primary

Addresses

Primary practice location

9050 Anthem Ave
Plainfield, IN 46168-4936

Mailing address

9050 Anthem Ave
Plainfield, IN 46168-4936
Phone (317) 771-8573

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181220000640 IN Practitioner - Occupational Therapist in Private Practice 1153666177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9050 Anthem Ave
Plainfield, IN 46168-4936
Phone (317) 771-8573

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31005423AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Evolution Therapy and Wellness LLC Occupational Therapist CurrentSince Sep 26, 2018 Accepting new patients

Locations

7393 Business Center Dr
Ste 100
Avon, IN 46123
Phone (317) 742-5055

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.

NPI Registry JSON

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

{
    "created_epoch": "1420243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1831587534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9050 ANTHEM AVE",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461684936",
            "telephone_number": "317-771-8573",
            "fax_number": "317-800-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9050 ANTHEM AVE",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461684936",
            "telephone_number": "317-742-5055",
            "fax_number": "317-800-6815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CHARISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-03",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31005423A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.