Individual provider Active NPI

Dallas Leigh Upchurch, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Temple, TX
National Provider Identifier
1013551233
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10009760 Issued in OR
Practice address
1901 Veterans Memorial Dr
Temple, TX 76504-7451
Phone
(254) 778-4811
NPI assigned
Oct 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10009760 OR Primary
Nurse Practitioner 363L00000X 10009760 OR

Addresses

Primary practice location

1901 Veterans Memorial Dr
Temple, TX 76504-7451

Mailing address

821 Kendra Dr
Temple, TX 76502-5878
Phone (706) 326-6088

Other practice location 1

5441 S.Maccadan Ave 8160
Portland, OR 97239
Phone (917) 265-9614

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2 Brighton Rd
Suite 300
Clifton, NJ 07012-1645

5441 S Maccadan Ave
Suite 8160
Portland, OR 97239

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10009760ORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Serenity Psychiatry, LLC CurrentSince Jan 4, 2026 Accepting new patients
Psychlife Mental Wellness LLC Psychiatric/Mental Health PastSince Jun 4, 2023 Accepting new patients

Organizations & group practices 2

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": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1013551233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 KENDRA DR",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765025878",
            "telephone_number": "706-326-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 VETERANS MEMORIAL DR",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765047451",
            "telephone_number": "254-778-4811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5441 S.Maccadan Ave 8160",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97239",
            "country_code": "US",
            "telephone_number": "917-265-9614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UPCHURCH",
        "first_name": "DALLAS",
        "middle_name": "LEIGH",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10009760",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "10009760",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.